The Social Construction of Global Health Priorities: An Empirical Analysis of Contagion in Bilateral Health Aid

Donors of development assistance for health typically provide funding for a range of disease focus areas, such as maternal health and child health, malaria, HIV/AIDS, and other infectious diseases. But funding for each disease category does not match closely its contribution to the disability and loss of life it causes and the cost-effectiveness of interventions. We argue that peer influences in the social construction of global health priorities contribute to explaining this misalignment. Aid policy-makers are embedded in a social environment encompassing other donors, health experts, advocacy groups, and international officials. This social environment influences the conceptual and normative frameworks of decision-makers, which in turn affect their funding priorities. Aid policy-makers are especially likely to emulate decisions on funding priorities taken by peers with whom they are most closely involved in the context of expert and advocacy networks. We draw on novel data on donor connectivity through health IGOs and health INGOs and assess the argument by applying spatial regression models to health aid disbursed globally between 1990 and 2017. The analysis provides strong empirical support for our argument that the involvement in overlapping expert and advocacy networks shapes funding priorities regarding disease categories and recipient countries in health aid.

China-EU Two-level Cooperation and Challenges on Public Health during the COVID-19

International public health cooperation has always been one of the typical issues of bilateral and multilateral diplomatic ties in the international community. As two important actors in the international community, China and the EU have worked on many transnational public health cooperation projects. The two-level division of the EU's foreign policy competence decided the Cooperation and Challenges on Public Health between China-EU. Cooperation with the EU member states is expanding, the cooperation with the level of the EU started to show up. Since the outbreak of COVID-19, both China and the EU have publicly expressed their support for WHO's anti-pandemic measures. China has actively provided public health aid to Central and Eastern European countries and shared the Anti-COVID-19 experience. In this article, the author reviewed the progress and mechanism of China-EU public health cooperation, discussed how China and the EU have jointly dealt with the pandemic by sharing experience, providing aids, strengthening multilateralism and international cooperation, and building a community with a healthy future for humankind since the outbreak of COVID-19. Facing the COVID-19，China-EU health cooperation should be further strengthened to show the importance of a community with a shared future for humanity.

Mitigating the externality of diseases of poverty through health aid

Externality exists in healthcare when an individual benefits from others being healthy as it reduces the probability of getting sick from illness. Healthy workers are considered to be the more productive labourers leading to a country’s positive economic growth over time. Several research studies have modelled disease transmission and its economic impact on a single country in isolation. We developed a two-country disease-economy model that explores disease transmission and cross-border infection of disease for its impacts. The model includes aspects of a worsening and rapid transmission of disease juxtaposed by positive impacts to the economy from tourism. We found that high friction affects the gross domestic product (GDP) of the lower-income country more than the higher-income country. Health aid from one country to another can substantially help grow the GDP of both countries due to the positive externality of disease reduction. Disease has less impact to both economies if the relative cost of treatment over an alternative (e.g. vaccination) is lower than the baseline value. Providing medical supplies to another country, adopting moderate friction between the countries, and finding treatments with lower costs result in the best scenario to preserve the GDP of both countries.

Trends and Outcomes of Early and Late Palliative Care Consultation for Adult Glioblastoma Patients: A SEER-Medicare Retrospective Study

PurposeGlioblastoma (GBM) carries a poor prognosis despite standard of care. Early palliative care (PC) has been shown to enhance survival and quality of life while reducing healthcare costs for other cancers. No study has investigated differences in PC timing on GBM patient outcomes.MethodsThis study used Surveillance, Epidemiology and End Results (SEER)-Medicare data from 1997-2016. Based on ICD codes, three groups were defined: (1) early PC within 10 weeks of diagnosis, (2) late PC, and (3) no PC. Outcomes were compared between the three groups.ResultsOut of 10,812 GBM patients, 1,648 (15.24%) patients had PC consultation with an overall positive trend over time. There were no significant differences in patient characteristics. There were significant differences in survival among the three groups (P<0.001), with early PC patients with the lowest mean time to death from diagnosis (3.99 ± 4.22 months). The early PC group had significantly lower overall cost of home health aid (1901 ± 3025, p<0.0001) and overall healthcare costs (82842 ± 52726, p<0.0001) compared to other groups. Conclusion We present the first investigation of PC consultation prevalence and outcomes, stratified by early versus late timing, for adult GBM patients. Despite an overall increase in PC consultations, only a minority of GBM patients receive PC. Patients with late PC had the longest survival times. Early PC was associated with lower healthcare costs and resource utilization when accounting for the patients’ entire disease course. Prospective studies can provide additional valuable information about this unique population of GBM patients.

Victims of the Terrorist Attacks in Belgium and Professional Mental Health Aid Barriers: A Qualitative Study

Introduction: Terrorist attacks can cause short and long-term stress-reactions, anxiety, and depression among those exposed. Sometimes, professional mental health aid, meaning all types of professional psychotherapy, would be appropriate, but victims often delay or never access mental health aid, even up to a decade after the initial event. Little is known about the barriers terrorist-victims encounter when they try to access professional mental health aid.Method: Using a qualitative design, 27 people exposed to the 22/03/2016 terrorist attack in Belgium were interviewed using half-structured, in-depth interviews, on their experiences with professional mental health aid. A reflexive thematic analysis was employed.Results: Five main barriers for professional mental health aid seeking by victims were found. First, their perception of a lack of expertise of mental health aid professionals. Second, the lack of incentives to overcome their uncertainty to contact a professional. Third, social barriers: people did not feel supported by their social network, feared stigma, or trusted that the support of their social network would be enough to get them through any difficulties. Fourth, a lack of mental health literacy, which seems to be needed to recognize the mental health issues they are facing. Finally, there are financial barriers. The cost of therapy is often too high to begin or continue therapy.Conclusions: This study showed that the barriers for seeking professional mental health aid are diverse and not easily overcome. More mental health promotion is needed, so that there is a societal awareness of possible consequences of being exposed to terrorist attacks, which might result in less stigma, and a quicker realization of possible harmful stress reactions due to a disaster.

Critical review of the use of financial incentives in solving health professionals' brain drain

This study critically reviewed the use of financial incentives in solving health professionals’ brain drain, with the view to ascertain its effectiveness. The Systematic Assessment Quantitative Technique (SQAT) developed by Catherine Pickering and Jason Antony Byrne, was used to identify and review 21 relevant peer-reviewed journal articles that investigated six forms of financial incentives in solving health professionals’ brain drain. Evidence from 66.67% of the studies showed that financial incentives are effective in solving health professionals’ brain drain through the use of improved remuneration, funded training, return subsidy and research grant. The remaining part of the studies (33.33%) did not find the use of financial health aid and bonding effective. This study recognized that financial incentives do not fully solve healthcare brain drain and other non-financial measures need to be implemented; future research work should therefore integrate other measures with financial incentives in order to gain additional insight on solving healthcare brain drain. The use of limited but high-quality academic databases means that some articles were not considered for review.