Despite a high disease burden, mental illness has thus far not achieved commensurate visibility, policy attention, or funding, the authors of this study note. They found that, while significant progress has been made in terms of prioritising mental health globally, debates around the definition of mental illness, and the continued impact of stigma, remain. The authors make five recommendations to increase the visibility and policy priority of mental health as a global issue. 1. Greater community cohesion and international governance structures need to be developed to contribute to a more unified voice regarding global mental health. 2. A common framework of integrated innovation is needed to ensure that global mental health speaks in the language of national and international policy makers. 3. For global mental health to gain significant attention, a coherent evidence base for scalable interventions that can be shown to have an impact at the structural level - on economic development and human well-being - is central. 4. A social justice and human rights approach is important. 5. Current innovative strategies for addressing stigma need to be evaluated and expanded.
Equity in Health
Development progress in the world's poorest countries could be halted or even reversed by mid-century unless bold steps are taken now to slow climate change, prevent further environmental damage, and reduce deep inequalities within and among nations, according to projections in the 2011 Human Development Report. In the report the United Nations Development Programme (UNDP) argues that environmental sustainability can be most fairly and effectively achieved by addressing health, education, income and gender disparities together with global action on energy production and ecosystem protection.
The deadline for meeting the Millennium Development Goals (MDGs) is quickly approaching. While progress has been made on a number of the goals, it is already clear that many targets will not be reached. Policy makers have been reluctant to start discussions of what comes after the 2015 deadline, fearing that negotiating a new framework would detract from efforts to meet the Millennium Development Goals (MDGs). While there seems to be broad support for a post- 2015 framework, there is not yet agreement on what this could look like. The United Nations and the World Health Organisation have started discussions on the issue, and it appears that sustainable development goals may be the way forward. In a survey of developing countries by the Institute of Development Studies, respondents overwhelmingly agreed that although the MDG framework has shortcomings, it is desirable to have an internationally agreed framework in place. Eighty percent of the respondents agreed that the post- 2015 arrangement should be target based, in part because it allows monitoring of progress.
Researchers in this study systematically collected all available data for malaria mortality for the period 1980–2010, correcting for misclassification bias. They found that global malaria deaths increased from 995,000 in 1980 to a peak of 1,817,000 in 2004, decreasing to 1,238,000 in 2010. In Africa, malaria deaths increased from 493,000 in 1980 to 1,613,000 in 2004, decreasing by about 30% to 1,133,000 in 2010. The researchers estimated more deaths in individuals aged 5 years or older than has been estimated in previous studies: 435,000 deaths in Africa and 89,000 deaths outside of Africa in 2010. In conclusion, the researchers assert that the malaria mortality burden is larger than previously estimated, especially in adults. There has been a rapid decrease in malaria mortality in Africa because of the scaling up of control activities supported by international funders. They argue that external funder support needs to be increased if malaria elimination and eradication and broader health and development goals are to be met.
While attention has focused on the rapid pace of urbanisation as the sole or major factor explaining the proliferation of informal settlements in developing countries, this paper argues that there are other factors that may have an effect. The paper accounts for differences in the prevalence of informal settlements among developing countries using data drawn from the recent global assessment undertaken by the United Nations Human Settlements Programme. The empirical analysis identifies substantial inter-country variations in the incidence of these settlements both within and across the regions of Africa, Asia as well as, Latin America and the Caribbean. Further analysis indicates that higher GDP per capita, greater financial depth and increased investment in infrastructure reduces the incidence of slums. Conversely, external debt burden, inequality in the distribution of income, rapid urban growth and the exclusionary nature of the regulatory framework governing the provision planned residential land directly contribute to the prevalence of informal settlements.
This study aimed to examine the longitudinal contributions of four political and socioeconomic factors to the increase in life expectancy in less developed countries (LDCs) between 1970 and 2004. Researchers collected 35 years of annual data for 119 LDCs on life expectancy at birth and on four key socioeconomic indicators: economy, educational environment, nutritional status and political regime. Results showed that the LDCs' increases in life expectancy over time were associated with all four factors. Political regime had the least influence on increased life expectancy in initial years but increased over time, while the impact of the other socioeconomic factors was initially stronger and decreased over time. Though authors argue that socioeconomic factors have strong impact on life expectancy, but the long-term impact of democracy should not be underestimated.
A number of key challenges to reproductive health in Namibia are identified: high fertility, especially among the poorest people and adolescents; an unmet need for contraception at 21%; women not using modern contraceptives because of health concerns or fear of side effects; and an increase in HIV among adults aged 15–49 years from 4% in 1992 to 20% in 2006. Knowledge of HIV prevention methods was found to be high. Key actions to improve reproductive health outcomes in Namibia were identified in this report as strengthening gender equality; reducing high fertility; highlighting the effectiveness of modern contraceptive methods and properly educating women on the health risks and benefits of such methods; and reducing maternal mortality and the prevalence of STIs/HIV/AIDS.
There are limited means to monitor the occurrence of cancer in developing countries and planning for prevention relies largely on estimates. This paper summarises priorities in cancer prevention in developing countries and the underlying evidence base, and addresses some of the challenges. The author concludes that cancer control calls for interventions that are kept logistically simple, integrated within systems and gradually building the infrastructure to bring care to the population at large. Given serious budgetary constraints, cancer control programmes need to maximise the efficacy of their investments. Of all possible interventions to reduce the cancer burden, the author argues that comprehensive programmes to prevent tobacco smoking are the most cost-effective, so that tobacco prevention should be a priority. Immunisation of infants against hepatitis B virus (HBV) is probably the second most cost-effective option in regions where the infection is still endemic. The author further argues that the uncontrolled use of carcinogens in industrial processes need to be addressed any cancer control programmes.
In 2011, there was important progress in a number of areas, according to the World Helath Organisation, with reports on AIDS, tuberculosis and malaria all indicating fewer deaths – and fewer new infections. The UN General Assembly met to agree a global agenda for noncommunicable diseases – only the second time (after HIV/AIDS) that a health-related theme was selected as the topic for a UN high-level meeting. Natural disasters and conflict took their toll. The year was marked by the earthquake, tsunami and nuclear power plant damage in Japan. Conflicts disrupted health services and added to health demands in a number of countries, notably in Libya, where WHO contributed to the health response, providing expertise and supplies. 2011 also continued to be marked by the world's financial crisis. This photo feature presents a selection of some of the major health issues in 2011.
Despite successes in global health to combat specific diseases, progress remains slow particularly in sub-Saharan Africa. In this paper, researchers discuss two challenges in the global health landscape currently: the changes in global health governance and the recurrent pendulum swing between horizontal (health systems focused) to vertical (single-disease focused) programming by external funders and agencies. Using Ethiopia as a case study, their analysis highlights leadership actions that promoted both vertical and horizontal objectives. These included: clarity and country ownership of purpose, authentic engagement with diverse partners, appropriately focused objectives, and the leveraging of management to mediate policy decisions and front-line action. The authors conclude that effective leadership in global health can reconcile vertical and horizontal objectives.