scholarly journals Democratizing Health Research

2020 ◽  
Author(s):  
Robert Fraser Terry ◽  
Erik Lieungh

Is it fair that researchers and policymakers in low-income countries have to pay to read new research on diseases they treat? Today's guest is Robert Terry from the World Health Organization’s Special Programme for Research and Training in Tropical Diseases (TDR), where he works as a manager of research policy. His background is from both the Royal Society and the Wellcome Trust. For Terry, achieving open access requires addressing barriers across political, technical and cultural barriers, with the culture of research assessment and reward needing the biggest change to democratizing science. The host of this episode is Erik Lieungh. This episode was first published 16 December 2019.

Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.


Molecules ◽  
2020 ◽  
Vol 25 (20) ◽  
pp. 4632 ◽  
Author(s):  
Jan Škubník ◽  
Michal Jurášek ◽  
Tomáš Ruml ◽  
Silvie Rimpelová

Cancer is one of the greatest challenges of the modern medicine. Although much effort has been made in the development of novel cancer therapeutics, it still remains one of the most common causes of human death in the world, mainly in low and middle-income countries. According to the World Health Organization (WHO), cancer treatment services are not available in more then 70% of low-income countries (90% of high-income countries have them available), and also approximately 70% of cancer deaths are reported in low-income countries. Various approaches on how to combat cancer diseases have since been described, targeting cell division being among them. The so-called mitotic poisons are one of the cornerstones in cancer therapies. The idea that cancer cells usually divide almost uncontrolled and far more rapidly than normal cells have led us to think about such compounds that would take advantage of this difference and target the division of such cells. Many groups of such compounds with different modes of action have been reported so far. In this review article, the main approaches on how to target cancer cell mitosis are described, involving microtubule inhibition, targeting aurora and polo-like kinases and kinesins inhibition. The main representatives of all groups of compounds are discussed and attention has also been paid to the presence and future of the clinical use of these compounds as well as their novel derivatives, reviewing the finished and ongoing clinical trials.


2011 ◽  
Vol 199 (1) ◽  
pp. 64-70 ◽  
Author(s):  
R. Bruffaerts ◽  
K. Demyttenaere ◽  
I. Hwang ◽  
W.-T. Chiu ◽  
N. Sampson ◽  
...  

BackgroundSuicide is a leading cause of death worldwide; however, little information is available about the treatment of suicidal people, or about barriers to treatment.AimsTo examine the receipt of mental health treatment and barriers to care among suicidal people around the world.MethodTwenty-one nationally representative samples worldwide (n=55 302; age 18 years and over) from the World Health Organization's World Mental Health Surveys were interviewed regarding past-year suicidal behaviour and past-year healthcare use. Suicidal respondents who had not used services in the past year were asked why they had not sought care.ResultsTwo-fifths of the suicidal respondents had received treatment (from 17% in low-income countries to 56% in high-income countries), mostly from a general medical practitioner (22%), psychiatrist (15%) or non-psychiatrist (15%). Those who had actually attempted suicide were more likely to receive care. Low perceived need was the most important reason for not seeking help (58%), followed by attitudinal barriers such as the wish to handle the problem alone (40%) and structural barriers such as financial concerns (15%). Only 7% of respondents endorsed stigma as a reason for not seeking treatment.ConclusionsMost people with suicide ideation, plans and attempts receive no treatment. This is a consistent and pervasive finding, especially in low-income countries. Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking.


2018 ◽  
Author(s):  
Mary Ricci

The maternal mortality rate (MMR) is unconscionably high around the world, with women in low to middle income countries (LMICs) disproportionately passing away from potentially preventable causes. While this is a complicated and multifaceted problem, anesthesia has been identified as a contributing cause of death. From the moment the parturient enters the operating room, the anesthetist is responsible for their well-being. This integrative review was designed to further explore relationship between anesthesia and the MMR in LMICs. Twelve articles published within the last 15 years were selected through an extensive literature search using Medline and CINAHL. Each article was examined using the Polit and Beck (2017) assessment criteria followed by a cross table analysis. The results identified common themes across the studies including lack of infrastructure such as access to reliable power, water and oxygen, resources such as medications and basic anesthesia equipment, training focusing on maternal care and anesthesia and continuing education for providers. Knowing these deficiencies in anesthetic care, nurse anesthetists can assist in implementing changes to help reduce the MMR. Recommendations include encouraging hospitals and governments to make updating hospital infrastructure a priority, reaching out to groups such as the World Health Organization who help fund basic equipment such as pulse oximeters, establishing relationships with medical institutions in other regions to provide training and guidance, and focusing on the development of non-physician anesthetist programs to increase the number of proficient providers.


Author(s):  
Andrea Ramírez Varela ◽  
Michael Pratt

In 2012, the Global Observatory for Physical Activity (GoPA!) was established to provide information that would enable countries to initiate or improve research capacity, surveillance systems, program development, and policymaking to increase physical activity levels. Findings from the first GoPA! Country Cards showed an unequal distribution of physical activity surveillance, research productivity, and policy development and implementation around the world. Regular global monitoring of these factors, especially in countries with the largest data gaps, was recommended to combat the global pandemic of physical inactivity. After 6 years and using standardized methods, GoPA! is launching the second set of Country Cards based on data up to 2019 from 217 countries. Overall results showed that periodic national surveillance of physical activity was less common in low-income countries, compared with middle- and high-income countries. Large inequities were seen with more than a 50-fold difference in publications between high- and low-income countries and 32% of the countries worldwide had no physical activity policy. GoPA! has a critical role in facilitating evidence-based physical activity promotion building on international guidelines and the World Health Organization Global Action Plan. GoPA! will continue to monitor progress as we battle the global pandemic of physical inactivity.


2021 ◽  
Author(s):  
Reshma Ramachandran ◽  
Joseph S. Ross ◽  
Jennifer E Miller

The COVID-19 pandemic has led to the rapid development of multiple vaccines, vaccines that were tested in clinical trials located in several countries around the world. Because prior research has shown that pharmaceuticals do not receive consistent and timely authorization for use in lower-income countries where they are tested, we conducted a cross-sectional study examining the authorization or approval and delivery for COVID-19 vaccines recommended by the World Health Organization (WHO) in the countries where they were tested. While countries of varying incomes have largely authorized the COVID-19 vaccines tested within their populations for use, high-income countries have received proportionately more doses, enabling them to more fully vaccinate their populations. As many lower-income countries continue to experience inequitable shortfalls in COVID-19 vaccine supply amid the ongoing pandemic, efforts must be undertaken to ensure timely access in countries across all income groups, including those hosting clinical trials.


2021 ◽  
Vol 22 (3) ◽  
pp. 185-191
Author(s):  
Dae Jung Kim ◽  
Jung Yeon Heo ◽  
Hyun Soo Kim

It has been a year and half since the World Health Organization declared the coronavirus disease 2019 (COVID-19) pandemic. As of July 23, 2021, more than 193 million people worldwide have been confirmed to contract the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with more than 4.15 million deaths. In Korea, about 185,000 people have been confirmed and 2,066 have died of COVID-19. Korea is in the middle of the fourth wave of trends, and the metropolitan area is in the top stage of social distancing. Since the SARS-CoV-2 vaccination began in the UK in December 2020, the number of people who complete vaccination is only 13.3% around the world, and many low-income countries have less than 5%. In Korea, the first vaccination rate was 32.27%, but only 13% completed the vaccination until July 23. As expected, there has been a lot of confusion, controversy, and even fake news and rumors over the past five months since the vaccination against COVID-19 began in Korea on February 26, 2021. People’s views on vaccination are bound to vary depending on their experience, perspective, and even political stance. In this article, we wanted to introduce the arguments and conflicts that could arise during vaccinations and suggest what we should think about so that many people can get vaccinated without hesitation.


2008 ◽  
Vol 5 (2) ◽  
pp. 27-28 ◽  
Author(s):  
John L. Cox

It is perhaps unusual for an academic journal like the Lancet to spearhead a ‘movement’ to advocate the scaling up of mental health services in low-income countries. Yet at the movement's launch in London in November 2007, attended by representatives from World Health Organization (WHO), the World Bank, donor agencies, as well as the World Psychiatric Association (WPA) and the Royal College of Psychiatrists, it was clear that a seminal series of papers, published in September of last year, was of the utmost importance for world psychiatry and for our planet. The five papers in the series ‘Global Mental Health’ had the following titles: ‘No health without mental health’; ‘Resources for mental health: scarcity, equity, and inefficiency’; ‘Treatment and prevention of mental disorders in low-income and middle-income countries’; ‘Mental health systems in countries: where are we now?’; and ‘Barriers to improvement of mental health services in low-income and middle-income countries’ (Lancet, September 2007, vol. 370, nos 9590–9593).


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