#National #spending on #health by #source for 184 countries between 2013 and 2040 (The Lancet, abstract)

[Source: The Lancet, full page: (LINK). Abstract, edited.]

National spending on health by source for 184 countries between 2013 and 2040

Joseph L Dieleman, PhD, Tara Templin, BA, Nafis Sadat, MA, Patrick Reidy, BA, Abigail Chapin, BA, Kyle Foreman, PhD, Annie Haakenstad, MA, Tim Evans, MD, Prof Christopher J L Murray, MD, Christoph Kurowski, MD

Published Online: 13 April 2016 / Article has an altmetric score of 10 / DOI: http://dx.doi.org/10.1016/S0140-6736(16)30167-2

© 2016 Elsevier Ltd. All rights reserved.




A general consensus exists that as a country develops economically, health spending per capita rises and the share of that spending that is prepaid through government or private mechanisms also rises. However, the speed and magnitude of these changes vary substantially across countries, even at similar levels of development. In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected.


We extracted data from WHO’s Health Spending Observatory and the Institute for Health Metrics and Evaluation’s Financing Global Health 2015 report. We converted these data to a common purchasing power-adjusted and inflation-adjusted currency. We used a series of ensemble models and observed empirical norms to estimate future government out-of-pocket private prepaid health spending and development assistance for health. We aggregated each country’s estimates to generate total health spending from 2013 to 2040 for 184 countries. We compared these estimates with each other and internationally recognised benchmarks.


Global spending on health is expected to increase from US$7·83 trillion in 2013 to $18·28 (uncertainty interval 14·42–22·24) trillion in 2040 (in 2010 purchasing power parity-adjusted dollars). We expect per-capita health spending to increase annually by 2·7% (1·9–3·4) in high-income countries, 3·4% (2·4–4·2) in upper-middle-income countries, 3·0% (2·3–3·6) in lower-middle-income countries, and 2·4% (1·6–3·1) in low-income countries. Given the gaps in current health spending, these rates provide no evidence of increasing parity in health spending. In 1995 and 2015, low-income countries spent $0·03 for every dollar spent in high-income countries, even after adjusting for purchasing power, and the same is projected for 2040. Most importantly, health spending in many low-income countries is expected to remain low. Estimates suggest that, by 2040, only one (3%) of 34 low-income countries and 36 (37%) of 98 middle-income countries will reach the Chatham House goal of 5% of gross domestic product consisting of government health spending.


Despite remarkable health gains, past health financing trends and relationships suggest that many low-income and lower-middle-income countries will not meet internationally set health spending targets and that spending gaps between low-income and high-income countries are unlikely to narrow unless substantive policy interventions occur. Although gains in health system efficiency can be used to make progress, current trends suggest that meaningful increases in health system resources will require concerted action.


Bill & Melinda Gates Foundation.

Keywords: Research; Abstracts; Public health.


A crucial #time for #public #health #preparedness: #Zika virus and the 2016 #Olympics, #Umrah, and #Hajj (The Lancet, extract)

[Source: The Lancet, full page: (LINK). Extract.]


A crucial time for public health preparedness: Zika virus and the 2016 Olympics, Umrah, and Hajj [      ]

Habida Elachola, Ernesto Gozzer, Jiatong Zhuo, Ziad A Memish

Published Online: 06 February 2016 / Publication stage: In Press Corrected Proof / DOI: http://dx.doi.org/10.1016/S0140-6736(16)00274-9

© 2016 Elsevier Ltd. All rights reserved.



The 138th session of WHO’s Executive Board on Jan 25, 2016, noted both the end of the 2014 Ebola crisis and the beginning of a global public health threat, the outbreak of Zika virus infection in the Americas.1 On Jan 15, 2016, the US Centers for Disease Control and Prevention advised pregnant women to refrain from travelling to countries affected by Zika, given a possible association between Zika virus infection with microcephaly and other neurological disorders.2 On Feb 1, 2016, WHO’s International Health Regulations Emergency Committee declared the possible association between Zika virus infection and clusters of microcephaly and other neurological disorders as a Public Health Emergency of International Concern.


Keywords: Research; Abstracts; Zika Virus; Public Health; Mass Gathering Events.


#Medical #care for #refugees: A question of #ethics and #public #health (Science Direct, extract)

[Source: Science Direct, full page. (LINK). Extract.]


Medical care for refugees: A question of ethics and public health [   R   ]

La atención médica a los refugiados: una cuestión ética y de salud pública

José Antonio Pérez-Molina a,∗, Miriam J. Álvarez-Martínez b, Israel
Molina c

a CSUR de Medicina Tropical, Servicio de Enfermedades Infecciosas, Hospital
Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; b Servicio de Microbiología,
Hospital Universitario Clínic de Barcelona, Barcelona, Spain; c Servicio de
Enfermedades Infecciosas, Hospital Universitario Vall d’Hebron, PROSICS, Barcelona, Spain



The United Nations High Commission for Refugees (UNHCR) 1951 Refugee Convention (July 28th) on the status of refugees defines a
refugee as a person who “owing to well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of  his nationality and is unable or, owing to such fear, is unwilling to  avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence as a result of such events, is unable or, owing to such fear, is unwilling to return to it”.1


Keywords: Research; Abstracts; Migrants; Public Health.


The #Ebola #Outbreak of 2014-2015: From Coordinated Multilateral Action to Effective Disease #Containment, #Vaccine Development, and Beyond (J Glob Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Glob Infect Dis. 2015 Oct-Dec;7(4):127-138.

The Ebola Outbreak of 2014-2015: From Coordinated Multilateral Action to Effective Disease Containment, Vaccine Development, and Beyond. [      ]

Wojda TR 1, Valenza PL 2, Cornejo K 2, McGinley T 2, Galwankar SC 3, Kelkar D 3, Sharpe RP 1, Papadimos TJ 4, Stawicki SP 1.

Author information: 1Department of Surgery, St. Luke’s University Health Network, Bethlehem, Pennsylvania and Phillipsburg, New Jersey, USA. 2Department of Family Medicine, St. Luke’s University Health Network, Bethlehem, Pennsylvania and Phillipsburg, New Jersey, USA. 3Department of Emergency Medicine, University of Florida, Jacksonville, Florida, USA. 4Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, Ohio, USA.



The Ebola outbreak of 2014-2015 exacted a terrible toll on major countries of West Africa. Latest estimates from the World Health Organization indicate that over 11,000 lives were lost to the deadly virus since the first documented case was officially recorded. However, significant progress in the fight against Ebola was made thanks to a combination of globally-supported containment efforts, dissemination of key information to the public, the use of modern information technology resources to better track the spread of the outbreak, as well as more effective use of active surveillance, targeted travel restrictions, and quarantine procedures. This article will outline the progress made by the global public health community toward containing and eventually extinguishing this latest outbreak of Ebola. Economic consequences of the outbreak will be discussed. The authors will emphasize policies and procedures thought to be effective in containing the outbreak. In addition, we will outline selected episodes that threatened inter-continental spread of the disease. The emerging topic of post-Ebola syndrome will also be presented. Finally, we will touch on some of the diagnostic (e.g., point-of-care [POC] testing) and therapeutic (e.g., new vaccines and pharmaceuticals) developments in the fight against Ebola, and how these developments may help the global public health community fight future epidemics.

KEYWORDS: Diagnostic and therapeutic update; Ebola outbreak; West Africa; epidemiology; socioeconomic developments

PMID: 26752867 [PubMed – as supplied by publisher]

Keywords: Research; Abstracts; Ebola; Public Health; Global Health.


Sharing #experiences from a reference #laboratory in the #public #health response for #Ebola, #MERS-CoV and #H7N9 #influenza virus investigations (ScienceDirect, abstract)

[Source: Science Direct, full page: (LINK). Abstract, edited.]

Asian Pacific Journal of Tropical Medicine / Available online 11 January 2016 / In Press, Accepted Manuscript / Open Access / Case Report

Sharing experiences from a reference laboratory in the public health response for Ebola viral disease, MERS-CoV and H7N9 influenza virus investigations  [      ]

T.S. Saraswathy Subramaniam (Senior Research Officer), Ravindran Thayan, Mohd Apandi Yusof, Jeyanthi Suppiah, Tg Abd Rashid Tengku Rogayah, Zarina Mohd Zawawi, Nor Aziyah Mat Rahim, Fauziah Kassim, Rozainanee Mohd Zain, Zainah Saat

Virology Unit, Institute for Medical Research, Kuala Lumpur 50558, Malaysia

Received 15 November 2015, Revised 20 December 2015, Accepted 30 December 2015, Available online 11 January 2016 / doi:10.1016/j.apjtm.2016.01.016



An efficient public health preparedness and response plan for infectious disease management is important in recent times when emerging and exotic diseases that hitherto were not common have surfaced in countries with potential to spread outside borders. Stewardship from a reference laboratory is important to take the lead for the laboratory network, to proactively set up disease surveillance, provide referral diagnostic services, on-going training and mentorship and to ensure coordination of an effective laboratory response. In Malaysia, the Institute for Medical Research has provided the stewardship for the Ministry of Health’s laboratory network that comprises of hospital pathology, public health and university laboratories. In this paper we share our experiences in recent infectious disease outbreak investigations as a reference laboratory within the Ministry of Health infectious disease surveillance network.

Keywords: Reference laboratory; Public health; Emerging diseases; Influenza A; MERS-CoV

Keywords: Research; Abstracts; Ebola; H7N9; Avian Influenza; MERS-CoV; Public Health; Malaysia.


Developing #Global #Norms for #Sharing #Data and #Results during #Public #Health #Emergencies (PLoS Med., abstract)

[Source: PLoS Medicine, full page: (LINK). Abstract, edited.]

Open Access / Policy Forum

Developing Global Norms for Sharing Data and Results during Public Health Emergencies [      ]

Kayvon Modjarrad,  Vasee S. Moorthy,  Piers Millett,  Pierre-Stéphane Gsell,  Cathy Roth,  Marie-Paule Kieny

Published: January 5, 2016 / DOI: 10.1371/journal.pmed.1001935

Citation: Modjarrad K, Moorthy VS, Millett P, Gsell P-S, Roth C, Kieny M-P (2016) Developing Global Norms for Sharing Data and Results during Public Health Emergencies. PLoS Med 13(1): e1001935. doi:10.1371/journal.pmed.1001935

Published: January 5, 2016

Copyright: © 2016 Modjarrad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Funding: The Wellcome Trust contributed towards the cost of the consultation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Provenance: Not commissioned; externally peer reviewed


Summary Points

  • Leading stakeholders from around the world convened at a WHO consultation in September 2015, where they affirmed that timely and transparent sharing of data and results during public health emergencies must become the global norm.
  • Representatives from major biomedical journals who attended the meeting agreed that public disclosure of information of relevance to public health emergencies should not be delayed by publication timelines and that early disclosure should not and will not prejudice later journal publication.
  • Researchers should be responsible for the accuracy of shared preliminary results, ensuring that they have been subjected to sufficient quality control before public dissemination.
  • Opting in to data sharing should be the default practice, and the onus should be placed on data generators and stewards at the local, national, and international level to explain any decision to opt out from sharing data and results during public health emergencies.
  • Incentives for sharing data should be created and tailored for each type of data generator and steward, while data management and analysis expertise is enhanced in under-resourced settings.


Keywords: Research; Abstracts; Public Health; Global Health; Emerging Diseases.


#Attacks on #HealthCare in #Syria — Normalizing #Violations of #Medical #Neutrality? (N Engl J Med., extract)

[Source: The New England Journal of Medicine, full page: (LINK). Extract.]


Attacks on Health Care in Syria — Normalizing Violations of Medical Neutrality? [   !   ]

Michele Heisler, M.D., M.P.A., Elise Baker, B.A., and Donna McKay, M.S.

N Engl J Med 2015; 373:2489-2491 / December 24, 2015 / DOI: 10.1056/NEJMp1513512


Interview with Dr. Michele Heisler on attacks on physicians and health care facilities in Syria and the response from the international community. (11:57)  –| Listen |—/ –| Download |–


In July 2015, a 26-year-old pediatrician described to our team of Physicians for Human Rights (PHR) investigators his experiences in Aleppo, Syria’s most populous city. When he was a medical student in 2012, government forces detained and severely beat him. He now works as an emergency medicine physician and surgery resident in a hospital that has twice been bombed by the Syrian government. He lives in fear of being killed by bombs on his way to work or while there. His family wants him to leave Syria as they did, but he explained, “It’s our country, and if we leave, it will fall apart. At times, I think maybe I will leave and specialize and come back with better skills, but then I see how much the people need me. Maybe that’s the biggest thing that’s keeping me inside.”


Keywords: Research; Abstracts; Wars; Public Health; Society; Bioethics.


#Public #funding for #research on #antibacterial #resistance in the JPIAMR countries, the #EC, and related #EU #agencies: a systematic observational analysis (The Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]


Public funding for research on antibacterial resistance in the JPIAMR countries, the European Commission, and related European Union agencies: a systematic observational analysis [      ]

Ruth Kelly, Ghada Zoubiane, Desmond Walsh, Rebecca Ward, Herman Goossens

Published Online: 18 December 2015 / Publication stage: In Press Corrected Proof / Open Access / DOI: http://dx.doi.org/10.1016/S1473-3099(15)00350-3

© 2015 Kelly et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.




Antibacterial resistant infections are rising continuously, resulting in increased morbidity and mortality worldwide. With no new antibiotic classes entering the market and the possibility of returning to the pre-antibiotic era, the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR) was established to address this problem. We aimed to quantify the scale and scope of publicly funded antibacterial resistance research across JPIAMR countries and at the European Union (EU) level to identify gaps and future opportunities.


We did a systematic observational analysis examining antibacterial resistance research funding. Databases of funding organisations across 19 countries and at EU level were systematically searched for publicly funded antibacterial resistance research from Jan 1, 2007, to Dec 31, 2013. We categorised studies on the basis of the JPIAMR strategic research agenda’s six priority topics (therapeutics, diagnostics, surveillance, transmission, environment, and interventions) and did an observational analysis. Only research funded by public funding bodies was collected and no private organisations were contacted for their investments. Projects in basic, applied, and clinical research, including epidemiological, public health, and veterinary research and trials were identified using keyword searches by organisations, and inclusion criteria were based on the JPIAMR strategic research agenda’s six priority topics, using project titles and abstracts as filters.


We identified 1243 antibacterial resistance research projects, with a total public investment of €1·3 billion across 19 countries and at EU level, including public investment in the Innovative Medicines Initiative. Of the total amount invested in antibacterial resistance research across the time period, €646·6 million (49·5%) was invested at the national level and €659·2 million (50·5%) at the EU level. When projects were classified under the six priority topics we found that 763 (63%) of 1208 projects funded at national level were within the area of therapeutics, versus 185 (15%) in transmission, 131 (11%) in diagnostics, 53 (4%) in interventions, and only 37 (3%) in environment and 39 (3%) in surveillance.


This was the first systematic analysis of research funding of antibacterial resistance of this scale and scope, which relied on the availability and accuracy of data from organisations included. Large variation was seen between countries both in terms of number of projects and associated investment and across the six priority topics. To determine the future direction of JPIAMR countries a clear picture of the funding landscape across Europe and Canada is needed. Countries should work together to increase the effect of research funding by strengthening national and international coordination and collaborations, harmonising research activities, and collectively pooling resources to fund multidisciplinary projects. The JPIAMR have developed a publicly available database to document the antibacterial resistance research collected and can be used as a baseline to analyse funding from 2014 onwards.


JPIAMR and the European Commission.

Keywords: Research; Abstracts; Antibiotics; Drugs Resistance; Public Health; EU.


Structural #Factors of the #MERS #Coronavirus #Outbreak as a #Public #Health #Crisis in #Korea and Future Response Strategies (J Prev Med Public Health, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Prev Med Public Health. 2015 Nov;48(6):265-70. doi: 10.3961/jpmph.15.066. Epub 2015 Nov 30.

Structural Factors of the Middle East Respiratory Syndrome Coronavirus Outbreak as a Public Health Crisis in Korea and Future Response Strategies. [      ]

Kim DH1.

Author information: 1Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea.



The recent Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak has originated from a failure in the national quarantine system in the Republic of Korea as most basic role of protecting the safety and lives of its citizens. Furthermore, a number of the Korean healthcare system’s weaknesses seem to have been completely exposed. The MERS-CoV outbreak can be considered a typical public health crisis in that the public was not only greatly terrorized by the actual fear of the disease, but also experienced a great impact to their daily lives, all in a short period of time. Preparedness for and an appropriate response to a public health crisis require comprehensive systematic public healthcare measures to address risks comprehensively with an all-hazards approach. Consequently, discussion regarding establishment of post-MERS-CoV improvement measures must focus on the total reform of the national quarantine system and strengthening of the public health infrastructure. In addition, the Korea Centers for Disease Control and Prevention must implement specific strategies of action including taking on the role of “control tower” in a public health emergency, training of Field Epidemic Intelligence Service officers, establishment of collaborative governance between central and local governments for infection prevention and control, strengthening the roles and capabilities of community-based public hospitals, and development of nationwide crisis communication methods.

KEYWORDS: Healthcare systems; Infectious disease outbreak; Korea; Middle East respiratory syndrome coronavirus; Public health

PMID: 26639738 [PubMed – in process]

Keywords: Research; Abstracts; S. Korea; MERS-CoV; Public Health.


#Ebola #Crisis Passes, but #Questions on #Quarantines Persist (NYT, Dec. 3 ‘15)

[Source: The New York Times, full page: (LINK).]

Ebola Crisis Passes, but Questions on Quarantines Persist [      ]


States often exceeded federal guidelines during the outbreak, sometimes with haphazard consequences, according to a new report.


Keywords: Ebola; Public Health; USA; Quarantine Measures; Civil Rights; Society.