International Public Health

A large proportion of non-communicable disease can be attributed to modifiable risk factors such as poor nutrition and physical inactivity. We present data on planning and transport practitioners' perceptions and responses to government public health guidance aimed at ...

In 1949, the Communist Party of China pledged that its approach to health care would differ markedly from that of the former Nationalist government and the "imperialist" West. For the next thirty years, under Mao's leadership, the People's Republic of China made improving the health of the entire population a central pillar of its policy. International health stakeholders came to view it as a statistical outlier in its ability to achieve better health outcomes with limited resources. The People's Health is the first systematic study of health care and medicine in Maoist China. Drawing on hundreds of files from rarely seen party archives and oral testimonies from experts, local cadres, and villagers across China, Zhou Xun shifts her historian's gaze away from official statistics towards the records of local institutions and personal memories that reflect and give voice to lived experiences. Through the everyday interactions of policy makers, national and local administration, and communities, Zhou illustrates the dynamic relationship between politics and health, and between individual lives and the political system. Presenting case studies of internationally acclaimed public health initiatives in the PRC - the anti-schistosomiasis campaign and the Barefoot Doctor program - this book offers the first thorough, politically neutral analysis of their background, execution, and national and international repercussions. Opening a unique window into the lives - and health care - of individuals living under communism, The People's Health examines the links between local interest, cultural sensibilities, resources, and abilities, exploring the often unforeseeable consequences of political planning and social engineering.

The question of why certain policy issues attract more attention than others is one that is of vital importance in any political environment. If an issue is high on the agenda of policy-makers, efforts to resolve it will bring with them a far greater concentration of resources and thus likelihood of success. This essay will look at two case studies from the field of international health, HIV/AIDS and the neglected tropical diseases (NTDs), through the lens of Shiffman and Smith's (2007) agenda-setting framework, examining the factors that determine how issues come to occupy a privileged position on the policy agenda. These factors include the power of the actors involved, the characteristics of the issue itself, and the political context, but also the way an issue is defined -its 'framing'. This essay will argue that while the way an issue is framed is a key determinant of political prioritisation in global health, at least in the cases presented, the success of a good framing is dependent on, and cannot be divorced from, the other factors identified in the framework.

Esta tese de doutorado tem como objeto a Campanha Continental para a Erradicação do Aedes aegypti, lançada pela Organização Sanitária Pan-Americana (OSP), em 1947. As suas origens, contudo, remontam à Campanha Mundial de Erradicação da Febre Amarela, idealizada em 1914 por Wycliffe Rose, o primeiro Diretor da Comissão de Saúde Internacional (CSI) da Fundação Rockefeller (FR), e iniciada oficialmente em 1918, após o término da Primeira Guerra Mundial (1914-1918). A Campanha se desenvolveu entre as décadas de 1910 e 1930, nas Américas e na África, tendo sido marcada por uma série de inflexões até ser reformulada nos anos da Segunda Guerra Mundial (1939-1945) e relançada, em 1947, sob os auspícios da OSP, na época dirigida por Fred Soper, um ex-funcionário da Fundação Rockefeller, com uma longa trajetória de atuação na América do Sul, no combate à doenças como a ancilostomíase, a malária e a febre amarela. Desta data até o final dos anos 1960, a meta de erradicar o vetor da febre amarela das Américas foi perseguida, com maior ou menor intensidade, por praticamente todas as Repúblicas americanas. O meu objetivo é analisar as origens, o desenvolvimento histórico, os impactos e as controvérsias suscitadas por este que foi o primeiro e mais duradouro programa internacional de erradicação de uma doença já implementado. A minha hipótese é que a Campanha Mundial de Erradicação da Febre Amarela da FR fortaleceu a cooperação interamericana em saúde, estreitando as relações entre as Repúblicas americanas entre as décadas de 1920 e 1940, processo que resultaria, no pós-Segunda Guerra Mundial, na Campanha Continental para a Erradicação do Aedes aegypt que, como procurarei mostrar, constituiu-se em uma nova fase da campanha da FR, só que em um outro contexto internacional. Assim, através da análise da Campanha, com os seus avanços, retrocessos e inflexões, em diferentes contextos políticos e sanitários, eu pretendo discutir a crescente cooperação internacional em saúde que vai se estabelecendo nas Américas ao longo do seu desenvolvimento. Também estou interessado nos impactos desta cooperação sobre o campo da saúde pública no Brasil e nos Estados Unidos, bem como sobre as relações científicas, sanitárias e políticas mantidas entre os dois países e entre eles e as demais Repúblicas americanas em torno da questão da febre amarela, antes e depois da Segunda Guerra Mundial. Os marcos cronológicos desta tese são os anos de 1918, quando a Campanha Mundial de Erradicação da Febre Amarela foi lançada pela Fundação Rockefeller, e 1968, quando problemas verificados nos Estados Unidos levaram ao abandono da Campanha Continental para a Erradicação do Aedes aegypti.

The purpose of this article is to highlight the present socio-economic impact of the rising prevalence of non-communicable diseases (NCD) on most countries of the world, and how such rising trend poses one of the greatest threats to the actualization of the Sustainable Development Goals in Africa.
The rising prevalence of NCD in many parts of the world have been identified as a threat not only to human health and wellbeing, but also to the sustainability of human developments and economic growth. More than before, economists are increasingly expressing concern that the rising threat of NCD will result in a worldwide long-term negative macroeconomic impacts on the quality and quantity of human resources, capital accumulation and Gross Domestic Product (GDP), with the consequences most severe in the developing countries.
According to the World Health Organization (WHO), the costs to health-care systems from NCD are already high; while significant costs to individuals, families, businesses, and governments are even higher, adding up to major negative macroeconomic impacts on most societies of the world. The greatest effects of NCD falls increasingly on the low- and middle-income countries (LMIC), and on the poorer people within all countries, mirroring the underlying socioeconomic determinants. This situation if unchallenged, will likely threaten the realization of the Sustainable Development Goals, with consequences far beyond the capacity of most African countries.
In conclusion, in order to avoid another failed developmental goals in Africa, the threat of NCD must be given all the seriousness it deserved at the highest level. As pointed out by many authorities, the best approach is to focus on preventive measures that effectively tackles the unhealthy risk factors implicated in the rising prevalence of NCD. This can be done partly through effective health education that focuses on lifestyle intervention.

The purpose of this thesis is to investigate potential key determinants of the success, or otherwise, of endeavours to address avoidable Visual Impairment (VI) by addressing Uncorrected Refractive Error (URE) in Mozambique and the wider region of sub-Saharan Africa by providing optometric services. It includes a Cost Benefit Analysis (CBA) of a higher education optometry training programme, barriers that might prevent the realisation of overarching goals despite a successful training programme, and a Willingness to Pay (WTP) analysis to inform the pricing structure and to determine the financial sustainability of the system. Methods A standard CBA methodology was applied to ascertain societal net benefit. Costs including those associated with establishing an optometry service. Benefits were calculated by considering how addressing URE could increase productivity. Disability weighting (DW) for VI was applied …

Background
A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016.

Methods
Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0–100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0–100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita.

Findings
In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8–98·1) in Iceland, followed by 96·6 (94·9–97·9) in Norway and 96·1 (94·5–97·3) in the Netherlands, to values as low as 18·6 (13·1–24·4) in the Central African Republic, 19·0 (14·3–23·7) in Somalia, and 23·4 (20·2–26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1–93·6) in Beijing to 48·0 (43·4–53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6–68·8) in Goa to 34·0 (30·3–38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries.

Interpretation
GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view—and subsequent provision—of quality health care for all populations.

  Stefania Negri (, influenza aviaria, epidemia influenzale HN) e dalla diffusione «epidemica» di alcune malattie non trasmissibili  , la comunità globale riconosce nella tutela della salute pubblica un interesse collettivo fondamentale, sforzandosi di raggiungere l'obiettivo ambizioso (e forse utopico) della copertura sanitaria universale  .

RESUMO Introdução: o Efeito Dunning-Kruger para pessoas com baixa autoestima refere-se a uma pessoa muito insegura que duvida de sua própria competência profissional, avaliando-se como uma fraude ou incapaz de desenvolver corretamente determinadas tarefas, não merecedor dos elogios e dos sucessos que atinge. Essa impressão pode ser oriunda da própria atividade metacognitiva em conjunção com sua humildade intelectual; todavia, há exageros na maneira como a pessoa lida com esses fatores. Objectivo Geral: compreender o efeito Dunning-Kruger em pessoas com baixa autoestima. Metodologia: Para o alcance do nosso objetivo, optou-se pelo método da revisão integrativa, visto que é a mais ampla abordagem metodológica referente às revisões, permitindo a inclusão de estudos experimentais e não-experimentais para uma compreensão completa do fenômeno analisado. Resultados: Os resultados encontrados apontaram que certas pessoas incompetentes em determinadas habilidades, superestimam suas capacidades no que tange aos seus critérios objetivos, possuindo desta forma um déficit em suas capacidades metacognitivas sendo pouco capazes, se comparado a pessoas mais hábeis, em distinguir respostas e afirmações realmente corretas. Indo além disso: são pouco capazes em observar o próprio erro se apenas terem como parâmetro o meio social onde estão inseridas, principalmente por não serem capazes de observar a capacidade de outras pessoas mais hábeis. Conclusão: o Efeito Dunning-Kruger ou a superioridade ilusória pode ser muito perigosa. Pessoas sob esse efeito falham em reconhecer sua própria falta de habilidade e falham em reconhecer as habilidades genuínas em outras pessoas. Por isso é importante estudar, pesquisar, se atualizar e treinar insistentemente. Duvide da sua competência em fazer boas análises, pois você pode estar sendo um afetado pela superioridade ilusória e nem sabe disso.

This paper aims at analyzing the COVID-19 pandemic emergency from the perspective of international public health law. After a brief introduction to the field, it addresses the relevant regulatory framework in order to understand the obligations binding upon States as well as the role played by the World Health Organization (WHO) in handling the crisis. Then, the article assesses the effectiveness of the 2005 International Health Regulations (IHR), which constitutes the main regulatory source in this matter, on the basis of the action taken by the WHO and the degree of compliance shown by States in the period between January and June 2020. Against this backdrop, the discussion outlines the fundamental architecture of the collective surveillance system and examines the most relevant acts adopted by the WHO so far. In this regard, some shortcomings have emerged in practice. Lastly, the paper analyzes the relevant means of dispute settlement and their deficiencies.

Research has shown that African-born immigrants to the U.S. have a high risk of HIV infection, and more than half of them reside in one of seven states with Massachusetts being home to more than 66,000 residents. As of 2009, the largest proportion of non-U.S. born persons in MA diagnosed with HIV infection was from Sub-Saharan Africa. Because only a few studies have focused on HIV-testing attitudes and stigma in this population, very little is known about how to provide culturally appropriate HIV prevention and screening activities, particularly among African-born men. Not only to they have a high rate of HIV seropositivity and present at a late stage of HIV disease, but they also experience significant HIV-related stigma. Moreover, barriers and misconceptions about the U.S. healthcare system and legal and linguistic challenges persist. Thus, the need to provide interventions to reduce barriers to HIV testing, decrease stigma, and increase access to healthcare services in this community emerged.

The COVID-19 pandemic continues to ravage the world, with the United States being highly affected. A vaccine provides the best hope for a permanent solution to controlling the pandemic. Several coronavirus disease (COVID-19) vaccines are currently in human trials. However, to be effective, a vaccine must be accepted and used by a large majority of the population. This study aimed to investigate the acceptability of COVID-19 vaccines and its predictors in addition to the attitudes towards these vaccines among public. This study did an online survey during the period June-September 2020, were collected from 26,852 individuals aged 19 years or older across six continents as part of 60 nationally representative surveys to determine potential acceptance rates and factors influencing acceptance of a COVID-19 vaccine. Results revealed that two-thirds of respondents were at least moderately worried about a widespread COVID-19 outbreak. Differences in acceptance rates ranged from almost 93% (in Tonga) to less than 43% (in Egypt). Respondents reporting higher levels of trust in information from government sources were more likely to accept a vaccine and take their employer's advice to do so. Systematic interventions are required by public health authorities to reduce the levels of vaccines' hesitancy and improve their acceptance. These results and specifically the low rate of acceptability is alarming to public health authorities and should stir further studies on the root causes and the need of awareness campaigns. These interventions should take the form of reviving the trust in national health authorities and structured awareness campaigns that offer transparent information about the safety and efficacy of the vaccines and the technology that was utilized in their production.

Introduction
Many interesting issues have been raised about the MDGs and SDGs, as it was after the millennium declaration that the world came to the realisation that much had to be done about the condition of the world issues. The SDGs centre on the development of goals that were put in place and are universally applied for and not only in developing countries. In understanding the question asked, I will consider the significance of the SDG 3 that is directly related to health and states that “Ensure healthy lives and promote well-being for all at all ages”. SDG3 includes maternal and child health, communicable as well as non-communicable diseases to mention but a few. The majority of countries have signed up to the Sustainable Development Goals (SDGs), which was the continuation of the MDGs agenda. It is clear that the SDGs are interdependent and the attainment of targets in one goal contributes to the attainment of the targets in other goals.
The WHO has pointed out the challenges presented with regard to monitoring given the number of targets and indicators as there are 23 health and health-related targets of which 13 are in SDG3 for health, with 35 indicators, 26 of which are in the health goal.
This has called for great action at country level for the development of country-specific frameworks with indicators and targets while taking into consideration global reporting obligations. The main requirement is the need for data on a broader set of health and health-related issues and information to monitor equity and while keeping the health MDG agenda. SDG3 embraces the growing challenge of non-communicable diseases and their risk factors and this has called for the need for a multi-level approach and monitoring challenges to health information systems of low-income and middle-income countries.

Applying the Roman Catholic Church’s set of moral principles on social concerns called Catholic social teaching (CST) on charity, distributive justice, private property and the common good, and utilising some secondary data and scientific literature, this article argues that establishing distributive justice for the global distribution of the COVID-19 vaccines must be a priority than donating millions of doses in the name of charity to address vaccine scarcity. Catholic social teaching teaches that the right to private property is a basic right but has moral limits and is subordinated to the moral principles on the universal destination of earth’s goods and the common good. Contribution: The current COVID-19 vaccines are developed by people and organisations outside the pharmaceutical companies and largely funded using taxpayers’ money. Thus, by virtue of justice, these vaccines must belong to all nations as global public health goods. Patents are to be suspended to allow poor countries to reproduce the popular vaccines and address the current vaccine shortage.

Una historia de la principal agencia multilateral de salud internacional de las Américas. Creada en 1902 y que después de la Segunda Guerra Mundial se transformó en la oficina regional de la Organización Mundial de la  Salud. Una historia donde se encuentran la perspectiva tecnocrática y la perspectiva social sobre la salud. Libro publicado por la Organizacion Panamericana de la Salud en Washington DC en el 2004 (Translated into English and Portuguese by The Univ. of Rochester Press, 2007 and Fiocruz, 2007)

The main goal of the book is to contribute to the history of the social policies and public health practices with respect to the so called “social diseases” and in particular to tuberculosis in Bulgaria from the turn of the 19th century up to the 1950s –  between social initiatives and state institutional engagements. The research is based  on original archival materials – arhives in Bulgarian Central State Archive of the Main Department of Public Health, the Civil Sanitary Direction, the Bulgarian doctors’ Union, the Society for the Fight against Tuberculosis in Bulgaria, the Rockefeller Foundation in Bulgaria, the Near-East Foundation in Bulgaria etc. In the analysis additional sources were attracted: books, press materials and historiography. The book provides a reconstruction of the general institutional frames, the interaction between the state and private institutions under the influence of the international medical organizations.
From the second half of the 19th century, tuberculosis increasingly engaged public attention, being identified as one of the most frequent reasons for sickness and death – thousands of people annually died and hundreds of thousands became invalid. Public discussions concerning the topic permanently reminded that the disease affected particularly the young and “prospective” generation. In Bulgaria tuberculosis considerably began to be viewed as a social problem at the end of the 19th century and all experts shared the same opinion: the fight against tuberculosis had to be preventive, that meant: improvement of hygiene and labor conditions, overall information about the disease aimed at reaching widest circles of the population and last not least, medical treatment.
In the early 20th century in Bulgaria 20 000 persons annually died from tuberculosis, which was one of the highest percentages in Europe at that time. The conquest of the tuberculosis seemed possible with the tools at hand. These tools included, first, isolation of infectious cases — concerns about heredity and constitution were replaced by concerns about infection- and, second, provision of rest, good nutrition, fresh air and education. But the elimination of tuberculosis required much more: it required above all official and voluntary action; patients should comply with all elements of control; betterment of those marginalized in society should be reached. Discipline and control became an increasingly dominant part of the treatment, being considered rather as end than means. Later, as tuberculosis control became a public responsibility, the state sanatoriums preempted the private institutions in terms of the numbers of beds, services offered, and public recognition.
The First World War marks a turning point in the overall orientation of Bulgarian antituberculosis efforts. Tuberculosis was considered as “social disease”. In the interwar period this term meant those diseases which are usually related to a given set of living or working conditions and were most common among specific socioeconomic groups. In the Bulgarian case tuberculosis, malaria, venereal diseases, alcoholism and, from the second half of the 1920s, also cancer, were treated as social diseases. Tuberculosis,  in particular, plagued the lower classes, due to their living and working conditions and poor nutrition; because of its epidemic character tuberculosis was considered a danger to the general state of health, economic productivity, military strength, and to the reproductive capacity of the society and the nation; many experts feared that tuberculosis was a symptom of the degeneration of the biological substance of the nation or race and that it was the mechanism through which hereditary weakness was perpetuated.
There is a reliable statistic for the death-rate and partly for the tuberculosis morbidity for the towns from 1925, when a statistic was established that registers death reasons in the towns. With the acceptance of the new Public Health Law in 1929 it is made obligatory to report the tuberculosis death-rate (but still there no data for morbidity).
The nation’s arsenal of dispensaries, sanatoriums, and related institutions which declared “war on tuberculosis”, in the reformers’ military terminology, was subject to increasingly anxious inventory and scrutiny. While Bulgaria have been slower than other countries in building antituberculosis facilities, it was hardly alone in allowing social anxieties and stereotypes to determine its response to the disease. Other preoccupations came to the fore when tuberculosis was perceived as a social problem or as a threat to the nation. In Bulgaria, efforts to curb the ravages of tuberculosis took place within a general framework that Paul Weindling has called “the hygienization of private life.”  In the crusade to bring more “air, light, and space” into the everyday lives, the blame for tuberculosis was related to poor diet, unsanitary living and working conditions, and alcoholism.
Bulgarian reformers (doctors and hygienists) placed also special emphasis on personal responsibility in the fight against tuberculosis. They promoted moderation, cleanliness, and a temperate lifestyle. The ethos of the individual responsibility in Bulgaria left a little space for genetic reasons, which were downplayed as a cause of tuberculosis. Spitting became central in the social etiology of tuberculosis.
From the early 20th century a group of physicians attempted to define the health problems within social and economic discourse, while protesting about the absence of public health statistics and the lack of public health system. The Anti-Tuberculosis Society set up in 1909 served as a typical example of facing such criticisms carried out by various charitable societies, established by medical authority. These active hygienists, educated abroad usually worked as medical officers and tried to fund TB dispensaries, sanatoria or other institutions for the relief of tuberculosis patients. Moreover they attempted to educate people by explaining sanitation in simple terms to the public and convincing politicians to provide against contagious diseases and to take action in order to strengthen those susceptible to diseases, particularly children.
Vigorous campaigns against spitting have been a nearly universal feature of the battles against the disease in this period. Throughout the 1920s and 1930s the state started to introduce standards and common bureaucratic rules of social work and centralized the public health care, including the fight against tuberculosis.  International models and standards influenced the tuberculosis control policies in Bulgaria – especially the activities of the League of Nations Health Organisation, the International Health Division of the Rockefeller Foundation and the American Near East Foundation.
Throughout the 1930s the balance between state and public initiatives, state institutions, media and societies was reached and new forms of collaboration were discovered. These new forms made possible free expression of different ideas, inspired by humane, religious, modern or nationalistic, socio-controlling and eugenic views. Keeping pluralism intact meant rivalry, but it also called for coordination between the separate institutions. The legislation tried to balance between the State and the associations, and to assist for the formation of partnership between them. However, the centralization effect gave rise to fears of excessive “nationalization” of the social activities in public health sphere. After 1934, the state introduced standards and common bureaucratic rules of social work and centralized the public health care. International models now influenced the social care organization in a rather tangible way – these international models and standards covered also social care for children, mothers-workers, destitute peasants, consumptive patients.
After 1945 the tendency to "nationalization" all practices of social assistances affected the Society for Fight against Tuberculosis as well. Until 1945 the Society formally existed in unchanged format with the main difference that from the winter of 1944 the former key figures in the Central Committee and in the Sofia branch of the Society were changed. In 1945 the Society was turned into the state National Union for Fight with Tuberculosis. The National Union continued to exist till July 1948, when with reference to the consolidation of the organisations and obeying to the decision of the Ministry Council, the Union dissolved in the Central Union of the “Red Cross”. Some of the statements printed in the reports of this First Congress in 1947 figured out the notions of the new rulers for former activities of the Society for Fight against Tuberculosis. The main motives in these statements focuses on the changes “before and after the 9th September 1944”. The speakers of the Congress qualified the anti-tuberculosis fight before the establishing of the “new power” as “an organization of cheap clemency and private charity” and insist in transforming the Union for Fight against Tuberculosis into a “mass” organization, which became a fact in 1948 –  the Society was transformed in a state organization and became a part of the Soviet system for health services.

É com imensa alegria que a contribuição cientifica gerada pelo o VI Encontro Nordestino de Fisioterapia na Saúde da Mulher -ENFISM será apresentada para comunidade acadêmica pela Revista Fisioterapia Brasil. Queremos compartilhar a produção cientifica na área da saúde da mulher, de autores de diversas universidades do Brasil com aqueles que se interessam pela promoção à saúde da mulher.

Following the recurrence of serious events of food contamination across the globe, food safety has become a matter of ever increasing international concern and the World Health Organization has defined foodborne diseases as a global public health challenge. Protecting global health from foodborne hazards is a compelling duty and a primary interest of both States and non-State actors; it calls for enhanced proactive cooperation between national and international institutions. Unfortunately, the present state of international law on food safety regulation and governance is still unsatisfactory and reforms are desirable in many respects. This paper suggests that improvements and progresses could be achieved in three major areas of intervention: a) the human rights framework, where the profile of the emerged right to safe food should be raised by way of express recognition in international human rights law, backed up by authoritative interpretation by the UN Committee on Economic, Social and Cultural Rights and strengthening of accountability and remedial measures; b) the regulatory framework, where trade and health issues related to food safety should be addressed in a way that contributes to easing tensions between trading parties while prioritizing consumer protection over freedom of trade; c) the sanitary framework, where international preparedness and response to public health hazards posed by foodborne diseases should benefit, where appropriate, from the extended application of the International Health Regulations and the possible devise of enforcement measures aimed at ensuring international health security.

The burgeoning scholarship on Western health films stands in stark contrast to the vacuum in the historical conceptualization of Eastern European films. This book develops a nonlinear historical model that revises their unique role in the inception of national cinematography and establishing supranational health security. Readers witness the revelation of an unknown history, concerning how the health films produced in Eastern European countries not only adopted Western patterns of propaganda but actively participated in its formation, especially with regard to those considered “others”: women and the populations of the periphery. The authors elaborate the long “echo” of the discursive practices introduced by health films within public health propaganda, as well as the attempts to negate and deconstruct such practices by rebellious filmmakers. A wide range of methods, including the analysis of the sociological biographies of filmmakers, the historical reconstruction of public campaigns against diseases, and an investigation into the production of health films, contextualizes these films along a multifaceted continuum stretching between the adaptation of global patterns and the cultivation of national authenticities. The book is aimed at those who study the history of film, the history of public health, Central and Eastern European countries, and global history.

Severe Acute Respiratory Syndrome (SARS) was the first emergent and highly transmissible viral disease to appear among humans during the twenty-first century. Caused by a coronavirus (SARS-CoV), SARS is far more lethal than the pandemic 2009 H1N1 influenza (caused by a Type A H1N1 influenza virus). Although less lethal than the H5N1 avian flu virus, the SARS virus is more transmissible among humans than the H5N1 virus.

The first known case of SARS was traced to a November 2002 case in Guangdong province, China. By mid-February 2003, Chinese health officials tracked more than 300 cases, including five deaths in Guangdong province from what was at the time described as an acute respiratory syndrome. Chinese health officials initially remained silent about the outbreak, and no special precautions were taken to limit travel or prevent the spread of the disease. The world health community, therefore, had no chance to institute early testing, isolation, and quarantine measures that might have prevented the subsequent global spread of the disease.

Under a new generation of political leadership, Chinese officials subsequently apologized for a slow and inefficient response to the SARS outbreak. Allegations that officials covered up the extent of the spread of the disease caused the dismissal of several local administrators, including China's public health minister and the mayor of Beijing.

In many regards, the SARS outbreak revealed what was effective in terms of public health responses, readiness, and resources. The outbreak also spurred reforms in the International Health Regulations (IHR) designed to increase both surveillance and reporting of infectious diseases and to enhance cooperation in preventing the international spread of disease. (download to read more)

Background

Public health interventions that are effective in the general population are often assumed to apply to people with impairments. However, the evidence to support this is limited and hence there is a need for public health research to take a more explicit account of disability and the perspectives of people with impairments.
 
Objectives

(1) To examine the literature on theories and models of disability; (2) to assess whether or not, and how, intervention studies of effectiveness could incorporate more inclusive approaches that are consistent with these theories and models; and (3) to use the findings to draw out implications for improving evaluative study designs and evidence-based practice.
 
Review methods

The project is a scoping review of the literature. The first stage examines theories and models of disability and reflects on possible connections between theories of disability and public health paradigms. This discussion is used to develop an ethical–empirical decision aid/checklist, informed by a human rights approach to disability and ecological approaches to public health. We apply this decision aid in the second stage of the review to evaluate the extent to which the 30 generic public health reviews of interventions and the 30 disability-specific public health interventions include the diverse experiences of disability. Five deliberation panels were also organised to further refine the decision aid: one with health-care professionals and four with politically and socially active disabled people.
 
Results

The evidence from the review indicated that there has been limited public health engagement with theories and models of disability. Outcome measures were often insensitive to the experiences of disability. Even when disabled people were included, studies rarely engaged with their experiences in any meaningful way. More inclusive research should reflect how people live and ‘flourish’ with disability.
 
Limitations

The scoping review provides a broad appraisal of a particular field. It generates ideas for future practice rather than a definite framework for action.
 
Conclusions

Our ethical–empirical decision aid offers a critical framework with which to evaluate current research practice. It also offers a resource for promoting more ethical and evidence-based public health research that is methodologically robust while being sensitive to the experiences of disability.
 
Future work

Developing more inclusive research and interventions that avoid conceptualising disability as either a ‘burden’ or ‘problem’ is an important starting point. This includes exploring ways of refining and validating current common outcome measures to ensure that they capture a diverse range of disabling experiences, as well as generating evidence on meaningful ways of engaging a broad range of disabled children and adults in the research process.

In the fifteen year period from 1964–1979, The People’s Republic of China engaged in an unprecedented number of domestic and international health campaigns that were utilized for China’s entrance onto the world stage. From Mao Zedong’s vision of a new form of medicine via the unification of Chinese medicines and biomedicine to the adoption of a Chinese model of healthcare integration and primary healthcare by the World Health Organization in the Declaration of Alma Ata, the PRC entered the world stage through its health exports and its distinctive adaptation of modernity to serve domestic, and often foreign policy goals. These exports include Sino-African health diplomacy; the globalization of Traditional Chinese Medicine, and in particular the global utilization and scientific recognition of the antimalarial artemisinin derived from the Chinese herb Qinghao ; and a model of primary and rural universal healthcare utilizing community health workers that garnered multilateral support. However, the face of benevolence displayed on the world stage was often contradicted by what was occurring domestically, behind the scenes, with the marked state enforcement of many of these same health campaigns in front of the backdrop of the cultural revolution. This paper examines if, and how, the West may have orientalized and romanticized China’s healthcare exports. Furthermore, we analyze the World Health Organization’s adoption and global promotion of a model for universal healthcare using healthcare integration that was only able to be achieved through the often brutal enforcement of the state, whilst rejecting grass-roots movements enacted during the same period, such as the practitioner-led integration of Ayurvedic medicine in India.

The construction of a tool for rating countries’ capacities to prevent, detect and respond to communicable diseases requires the identification of factors of epidemic risk as well as of government capacities to mitigate these. The Joint External Evaluation Tool (JEET) provides a set of indicators to monitor a country’s progress in the implementation of the International Health Regulations and for a rating of epidemic- related capacities. Therefore, the specification of the existing indicators to health emergencies caused by communicable diseases, the identification of additional or proxy indicators and the consideration of their potential quantification are required. The analysis includes a systematic review of the JEET according to criteria of objectivity, reliability and validity, and a literature research to identify related indicators and to discuss their relevance and potential integration into a rating tool.

Este capítulo analiza la pandemia de la COVID-19 como materialización de lo que el sociólogo Ulrich Beck denominaba un «riesgo global». Su impacto y efectos y, en particular, la crisis económica y social que ha iniciado la COVID-19, no se explican solo ni principalmente por las características del agente patógeno que le da origen. Se deben en gran medida a normas e instituciones sociales y a tendencias en el sistema internacional que ya estaban presentes antes de la pandemia. Frente a la COVID-19, han predominado las respuestas en clave nacional, en un contexto de multilateralismo contestado y de crisis de globalización. El capítulo destaca que la COVID-19 puede convertirse en una crisis de desarrollo si no se amplía el espacio fiscal y de políticas para la respuesta sanitaria, el apoyo al ingreso y el empleo de los más vulnerables, y la recuperación posterior. Ello demanda respuestas más amplias por parte de la cooperación internacional.

This is a summary of a master thesis and its six chapters, 151 pages and 213 pieces of literature. This article examines the regulatory framework for managing psychosocial risks in the European Union, focusing on the implementation challenges of the Participatory Intervention from an Organizational Perspective (PIOP) model. Through a case study of a higher education institution in Austria, the study highlights the complexities of aligning organizational practices with European directives, such as the EU Framework Directive 89/391/EEC on Safety and Health at Work. The findings emphasize the importance of regulatory compliance and active stakeholder participation in overcoming the challenges inherent in psychosocial risk management. It is argued an analysis such as this can be used as a proxy to design and implement any kind of change in organisations, thus be a tool for managing change.

Unlike the duties of clinicians to patients, professional standards for ethical practice are not well defined in public health. This is mainly due to public health practice having to reconcile tensions between public and private interest(s). This involves at times being paternalistic, while recognising the importance of privacy and autonomy, and at the same time balancing the interests of some against those of others. The Public Health specialist operates at the macro level, frequently having to infer the wishes and needs of individuals that make up a population and may have to make decisions where the interests of people conflict. This is problematic when devising policy for small populations; however, it becomes even more difficult when there is responsibility for many communities or nation states. Under the Treaty on European Union, the European Commission was given a competence in public health. Different cultures will give different moral weight to protecting individual interes...

This paper offers a critical perspective on the future of humanitarianism, drawing on the experience of four Latin American emerging countries: Brazil, Chile, Colombia and Mexico.

Their experience in the region and beyond provides a mix of characteristics that result in a unique understanding of crisis and response. Latin America is rather well-off and—except for Haiti—is mostly outside the scope of major humanitarian emergencies. However, Latin America is still affected by high inequality, organized crime, and all types of disasters, while hosting a major population displacement in Colombia as a result of civil conflict. Thus, emerging countries of the region remain on the global humanitarian watch list.

The paper explores this duality, based on over one hundred semi-structured interviews in the selected countries, complemented with direct observations and primary data analysis. Among significant findings, the paper describes a historical resistance from the region to be seen as the locus of humanitarian crisis, reflected both through capacity building and diplomacy. At least four older and more recent principles of action are identified, namely ‘non-indifference’, ‘reciprocity’, ‘sustainability’, and ‘horizontality’. In particular, horizontality underscores a rich diversity of South-South exchanges between line ministries and other offices in charge of specific crises that goes beyond being ‘donors’. Indeed, emerging countries explicitly challenge the traditional humanitarian establishment, so their contributions are better understood as reflecting ongoing transformations in their human development and security agendas.

Laut den aktuellen Angaben der Weltgesundheitsorganisation (WHO) sind weltweit 2,3 Milliarden Menschen übergewichtig. Neben unzureichender Bewegung stellt eine ungesunde Ernährungsweise die häufigste Ursache für Übergewicht dar. Eine derartige Lebensweise führt zwangsläufig zu zahlreichen, sog nichtübertragbaren Erkrankungen (noncommunicable diseases), wie etwa Bluthochdruck, Diabetes sowie zu Erkrankungen des Herz-Kreislauf-Systems. Insoweit erscheint es gerechtfertigt, wenn bisweilen davon gesprochen wird, dass Sitzen das neue Rauchen sei.So werden parallel zu den Bestrebungen im Kampf gegen den Tabakkonsum Einheitsverpackungen auch in Bezug auf ungesunde Produkte in Erwägung gezogen. Von dieser Maßnahme dürften künftig insb Alkoholprodukte betroffen sein. Der vorliegende Beitrag widmet sich daher der Frage, ob diese Maßnahmen mit europäischem Recht, insb mit der Eigentumsgarantie des Art 17 EU-Grundrechtecharta (GRC), zu vereinbaren sind.

When discussing women’s rights in the global arena, some experts in the field of gender equality would argue that North America, specifically the United States, are leaders in the advancement of women’s rights. In the United States, although there have been important advancements within the past few decades, there are still some areas where there could be significant improvement. When it comes to the topic of Female General Mutilation/Cutting, abbreviated as FGM/C, there has been significant research conducted on FGM/C in other countries (Hosken, 1981; Morrone & Hercogova & Lotti, 2002; Okeke & Anyaehie & Ezenyeaku, 2012). However, FGM/C also impacts American society, female citizens in particular, and their families. There has been a number of on going legislations introduced to Congress (H.Res.106, 2019; S. Res. 494, 2020) in the United States to prohibit FGM/C, however there is no federal law, therefore it can be argued that the government is not doing enough to protect its female citizens.
According to past research regarding FGM/C, there are scholars who address this cultural practice from a comparative standpoint, comparing FGM/C to other seemingly mundane culturally accepted practices that can be seen as similar to the procedure of FGM/C. Comparing FGM/C with other similar cultural practices practiced within the United States draws emphasis on the moral hypocrisy that often surrounds the discourse about FGM/C. As previously stated, FGM/C is practiced worldwide in many African and Asian countries, however it is also practiced in the United States, in part due to migration patterns. Additionally, it is practiced in the United States by natural born citizens that upholds conversative values regarding young girls. The practice has even impacted my home state, New Jersey and the surrounding areas, such as New York, Maryland, and Pennsylvania (Mather & Feldman-Jacobs, 2016).
This research paper seeks to explore whether or not the United States is doing enough to protect young women and girls against the practice of FGM/C. Can the United States do more to protect young girls and women?
Based on the results of this research that indicated inconsistent policy development and implementation to address this problem, it is recommended that the Federal government focus on providing centralized provisional policies towards community education and outreach for all states. The government should not leave this issue up to individual states because when it falls into the states’ individual hands, it leaves room for state governments to procrastinate and potentially ignore the social impact such a practice can have on young girls and women.

In a world where invasive alien species (IAS) are recognised as one of the major threats to biodiversity, leading scientists from five continents have come together to propose the concept of developing an international association for open knowledge and open data on IAS—termed " INVASIVESNET ". This new association will facilitate greater understanding and improved management of invasive alien species (IAS) and biological invasions globally, by developing a sustainable network of networks for effective knowledge exchange. In addition to their inclusion in the CBD Strategic Plan for Biodiversity, the increasing ecological, social, cultural and economic impacts associated with IAS have driven the development of multiple legal instruments and policies. This increases the need for greater coordination , cooperation , and information exchange among scientists, management, the community of practice and the public. INVASIVESNET will be formed by linking new and existing networks of interested stakeholders including international and national expert working groups and initiatives, individual scientists, database managers, thematic open access journals, environmental agencies, practitioners, managers, industry, non-government organisations, citizens and educational bodies. The association will develop technical tools and cyberinfrastructure for the collection, management and dissemination of data and information on IAS; create an effective communication platform for global stakeholders; and promote coordination and collaboration through international meetings, workshops, education, training and outreach. To date, the sustainability of many strategic national and international initiatives on IAS have unfortunately been hampered by time-limited grants or funding cycles. Recognising that IAS initiatives need to be globally coordinated and ongoing , we aim to develop a sustainable knowledge sharing association to connect the outputs of IAS research and to inform the consequential management and societal challenges arising from IAS introductions. INVASIVESNET will provide a dynamic and enduring network of networks to ensure the continuity of connections among the IAS community of practice, science and management.

Abstract—Distance Learning in Population Issues (DLPI) is
a distance education program offered by United Nations
Population Fund (UNFPA) in collaboration with Central
American Population Center of University of Costa Rica
(CCP-UCR) and Mauritius Institute of Health (MIH) of the
Mauritius Ministry of Health & Quality of Life.
The program consists of 7 courses on population and health;
participants receive materials and tutoring over the Internet
(email and other means of communication, 40 hours of
participation). Tutoring can be in English, Spanish or
French, according to preference of participants. Since 2005,
external partners and UNFPA are collaborating in this
program. Program administration is located in Central
America, management at UNFPA headquarters and
tutoring at both Central America and Africa. Participants
register online from many countries worldwide, registration
from 104 countries were received last year.
The program is offered in 8-week periods for 7 courses and
organized in 4-5 yearly terms. Each course is either tutored
by an English-French spoken tutor or by an English-
Spanish tutor.
Results show a mean completion rate of 61,3 ± 7 with a
median of 61,2 in 2005-2011. Participants evaluate course
tutoring and administration after it finishes. Evaluation
results are anonymous and participants comments are
submitted to each tutor in order to know what worked well
and what did not in the course.
DLPI is an ongoing experience of inter institutional
collaboration between an international cooperation
institution (UNFPA) and external partners (higher
education and health public institutions) which contributes
to continued education of workers.
Index Terms—Distance Education, Distance Learning,
Training Support, Capacity Building.