scholarly journals The rise and fall of global health issues: an arenas model applied to the COVID-19 pandemic shock

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Stephanie L. Smith ◽  
Jeremy Shiffman ◽  
Yusra Ribhi Shawar ◽  
Zubin Cyrus Shroff
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Global Health ◽  
News Media ◽  
Agenda Setting ◽  
Systematic Investigation ◽  
Health Issues ◽  
Focusing Events ◽  
Health Agenda ◽  
Hiv Aids

Abstract Background The global health agenda is ill-defined as an analytical construct, complicating attempts by scholars and proponents to make claims about the agenda status of issues. We draw on Kingdon’s definition of the agenda and Hilgartner and Bosk’s public arenas model to conceptualize the global health agenda as those subjects or problems to which collectivities of actors operating nationally and globally are paying serious attention at any given time. We propose an arenas model for global health agenda setting and illustrate its potential utility by assessing priority indicators in five arenas, including international aid, pharmaceutical industry, scientific research, news media and civil society. We then apply the model to illustrate how the status of established (HIV/AIDS), emergent (diabetes) and rising (Alzheimer’s disease) issues might be measured, compared and change in light of a pandemic shock (COVID-19). Results Coronavirus priority indicators rose precipitously in all five arenas in 2020, reflecting the kind of punctuation often caused by focusing events. The magnitude of change varied somewhat by arena, with the most pronounced shift in the global news media arena. Priority indicators for the other issues showed decreases of up to 21% and increases of up to 41% between 2019 and 2020, with increases suggesting that the agenda for global health issues expanded in some arenas in 2020— COVID-19 did not consistently displace priority for HIV/AIDS, diabetes or Alzheimer’s disease, though it might have for other issues. Conclusions We advance an arenas model as a novel means of addressing conceptual and measurement challenges that often undermine the validity of claims concerning the global health agenda status of problems and contributing causal factors. Our presentation of the model and illustrative analysis lays the groundwork for more systematic investigation of trends in global health agenda setting. Further specification of the model is needed to ensure accurate representation of vital national and transnational arenas and their interactions, applicability to a range of disease-specific, health systems, governance and policy issues, and sensitivity to subtler influences on global health agenda setting than pandemic shocks.

The Politics of Global Health Agenda Setting

2018 ◽  
pp. 324-345
Author(s):  
Stephanie L. Smith ◽  
Jeremy Shiffman
Keyword(s):  
Global Health ◽  
Agenda Setting ◽  
Single Case ◽  
Problem Definition ◽  
Future Research ◽  
Health Issues ◽  
Trade Regimes ◽  
High Level ◽  
To Receive ◽  
Health Agenda

This chapter examines the politics of global health agenda setting, the process by which global health issues come to receive attention from actors that control or influence the allocation of financial, technical, human, and other kinds of resources. It suggests that the global health agenda is shaped by the capabilities of actors, including policy entrepreneurs, high-level champions, and networks; ideas, especially those surrounding problem definition, solutions, and causal stories; powerful interests, such as the economic and security concerns of wealthy countries and industries; and institutions, such as international law and trade regimes. Most studies of global health agenda setting are of a single case, and many are descriptive. To build the field, future research should supplement these studies with comparative, theoretically grounded inquiry.

CLINICAL AND COST-EFFECTIVENESS OF DONEPEZIL, RIVASTIGMINE, AND GALANTAMINE FOR ALZHEIMER'S DISEASE

2002 ◽  
Vol 18 (3) ◽  
pp. 497-507 ◽  
Author(s):  
Andrew Clegg ◽  
Jackie Bryant ◽  
Tricia Nicholson ◽  
Linda McIntyre ◽  
Sofie De Broe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cost Effectiveness ◽  
Global Health ◽  
Cochrane Library ◽  
The Impact ◽  
Health Cognition ◽  
Economic Studies

Objectives: Systematic review of the clinical and cost-effectiveness of donepezil, rivastigmine, and galantamine for people suffering from Alzheimer's disease.Methods: Sixteen electronic databases (including MEDLINE, the Cochrane Library, and Embase) and bibliographies of related papers were searched for published/unpublished English language studies, and experts and pharmaceutical companies were consulted for additional information. Randomized controlled trials (RCTs) and economic studies were selected. Clinical effectiveness was assessed on measurement scales assessing progression of Alzheimer's disease on the person's global health, cognition, functional ability, behavior and mood, and quality of life. Cost-effectiveness was presented as incremental cost per year spent in a nonsevere state (by Mini Mental Health State Examination) or quality-adjusted life-year.Results: Twelve of 15 RCTs included were judged to be of good quality. Although donepezil had beneficial effects in Alzheimer's patients on global health and cognition, rivastigmine on global health, and galantamine on global health, cognition, and functional scales, these improvements were small and may not be clinically significant. Measures of quality of life and behavior and mood were rarely assessed. Adverse effects were usually mild and transient. Cost-effectiveness base case estimates ranged from £2,415 savings to £49,476 additional cost (1997 prices) per unit of effect for donepezil and a small savings for rivastigmine. Estimates were not considered robust or generalizable.Conclusions: Donepezil, rivastigmine, and galantamine appear to have some clinical effect for people with Alzheimer's disease, although the extent to which these translate into real differences in everyday life remains unclear. Due to the nature of current economic studies, cost-effectiveness remains uncertain and the impact on different care sectors has been inadequately investigated. Further research is needed to establish the actual benefits of acetylcholinesterase inhibitors (AChEls) for people with Alzheimer's disease and their caregivers, the relationship of these changes to clinical management, and careful prospective evaluation of resource and budgetary consequences.

scholarly journals Alzheimer’s Disease Diagnostics Must Be Globally Accessible

2021 ◽  
pp. 1-3
Author(s):  
Nicholas Clute-Reinig ◽  
Suman Jayadev ◽  
Kristoffer Rhoads ◽  
Anne-Laure Le Ny
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Global Health ◽  
Low Cost ◽  
High Income ◽  
Middle Income ◽  
Middle Income Countries ◽  
Disease Diagnostics ◽  
Low And Middle Income

Dementia and Alzheimer’s disease (AD) are global health crises, with most affected individuals living in low- or middle-income countries. While research into diagnostics and therapeutics remains focused exclusively on high-income populations, recent technological breakthroughs suggest that low-cost AD diagnostics may soon be possible. However, as this disease shifts onto those with the least financial and structural ability to shoulder its burden, it is incumbent on high-income countries to develop accessible AD healthcare. We argue that there is a scientific and ethical mandate to develop low-cost diagnostics that will not only benefit patients in low-and middle-income countries but the AD field as a whole.

scholarly journals Is there a pathological way of ageing?

2020 ◽  
Vol 4 (2) ◽  
pp. 60-69
Author(s):  
Patrick Cloos
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Global Health ◽  
Social Intervention ◽  
Sociocultural Context ◽  
Anthropological Perspective ◽  
Medical Object ◽  
Medical Category

This think piece discusses ‘Alzheimer’s disease’ from a critical anthropological perspective. I aim to challenge the taken-for-granted biomedical framing in four steps. First, a brief genealogical account shows that Alzheimer’s disease as a biomedical category has only recently become a public and global health preoccupation. Second, the concept of medicalization is mobilized to illustrate the construction of and the uncertainty around this new medical object. Third, I build a case for analysing this medical category within a sociocultural context. Finally, a brief account of the relevance of social intervention is given.

scholarly journals Alzheimer’s Disease Pharmacotherapy in Relation to Cholinergic System Involvement

Biomolecules ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 40 ◽  
Author(s):  
Gabriela Dumitrita Stanciu ◽  
Andrei Luca ◽  
Razvan Nicolae Rusu ◽  
Veronica Bild ◽  
Sorin Ioan Beschea Chiriac ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Global Health ◽  
Disease Progression ◽  
Cholinergic System ◽  
Cholinesterase Inhibitors ◽  
Current Understanding ◽  
Brain Functioning ◽  
System Involvement ◽  
Global Health Challenge

Alzheimer’s disease, a major and increasing global health challenge, is an irreversible, progressive form of dementia, associated with an ongoing decline of brain functioning. The etiology of this disease is not completely understood, and no safe and effective anti-Alzheimer’s disease drug to prevent, stop, or reverse its evolution is currently available. Current pharmacotherapy concentrated on drugs that aimed to improve the cerebral acetylcholine levels by facilitating cholinergic neurotransmission through inhibiting cholinesterase. These compounds, recognized as cholinesterase inhibitors, offer a viable target across key sign domains of Alzheimer’s disease, but have a modest influence on improving the progression of this condition. In this paper, we sought to highlight the current understanding of the cholinergic system involvement in Alzheimer’s disease progression in relation to the recent status of the available cholinesterase inhibitors as effective therapeutics.

scholarly journals COMBINATION THERAPY OF ANTI-TAU AND ANTI-AMYLOID DRUGS FOR DISEASE MODIFICATION IN EARLY-STAGE ALZHEIMER’S DISEASE: SOCIO-ECONOMIC CONSIDERATIONS MODELED ON TREATMENTS FOR TUBERCULOSIS, HIV/AIDS AND BREAST CANCER

2015 ◽  
pp. 1-9
Author(s):  
S. Tomaszewski ◽  
S. Gauthier ◽  
A. Wimo ◽  
P. Rosa-Neto
Keyword(s):  
Breast Cancer ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Combination Therapy ◽  
Early Stage ◽  
Universal Access ◽  
Senile Plaques ◽  
Tau Proteins ◽  
Economic Implications ◽  
Hiv Aids

Current drugs for treatment of mild to severe dementia of the Alzheimer’s type include cholinesterase inhibitors and the NMDA non-competitive receptor antagonist memantine. There is controversy as to the additive benefit of these symptomatic drugs, and their effects are clinically modest. Patients with Alzheimer’s disease (AD) are known to have characteristic pathology, including senile plaques with amyloid beta-protein aggregates and neurofibrillary tangles with assembled tau proteins, which start in the hippocampus and spread to neighboring areas. Amyloid and tau modifying drugs are under clinical testing. Based on this pathophysiology, it is crucial to investigate whether anti-amyloid and anti-tau combined therapy would show efficacy in early stage of AD, beyond what could be achieved with anti-amyloid or anti-tau monotherapy. It is equally important to consider the socio-economic implications of such a combination therapy, if effective. We hypothesize that the high costs of combination therapy for early-stage AD patients will require societal and public health initiatives to ensure universal access to AD treatment. In order to better predict these socio-economic implications, we summarize the management of other combination therapies used for tuberculosis, HIV/AIDS, and breast cancer, based on a database search of PubMed and other relevant sources. We put forward a framework for testing a potential anti-amyloid and anti-tau disease modifying combination therapy for early-stage AD patients and present an analysis of the socio-economic implications of such a combination therapy.

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