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This is a community-based, retrospective, observational study conducted to determine effectiveness of the BBIBP-CorV inactivated vaccine in the real-world setting against hospital admissions and death.Study participants were selected from 214,940 PCR-positive cases of COVID-19 reported to the Department of Health, Abu Dhabi Emirate, United Arab Emirates (UAE) between September 01, 2020 and May 1, 2021. Of these, 176,640 individuals were included in the study who were aged ≥ 15 years with confirmed COVID-19 positive status who had records linked to their vaccination status. Those with incomplete or missing records were excluded (n = 38,300). Study participants were divided into three groups depending upon their vaccination status: fully vaccinated (two doses), partially vaccinated (single dose), and non-vaccinated. Study outcomes included COVID-19-related admissions to hospital general and critical care wards and death. Vaccine effectiveness for each outcome was based on the incidence density per 1000 person-years.The fully-, partially- and non-vaccinated groups included 62,931, 21,768 and 91,941 individuals, respectively. Based on the incidence rate ratios, the vaccine effectiveness in fully vaccinated individuals was 80%, 92%, and 97% in preventing COVID-19-related hospital admissions, critical care admissions, and death, respectively, when compared to the non-vaccinated group. No protection was observed for critical and non-critical care hospital admissions for the partially vaccinated group, while some protection against death was apparent, although statistically insignificant.In a COVID-19 pandemic, use of the Sinopharm BBIBP-CorV inactivated vaccine is effective in preventing severe disease and death in a two-dose regimen. Lack of protection with the single dose may be explained by insufficient seroconversion and/or neutralizing antibody responses, behavioral factors (i.e., false sense of protection), and/or other biological factors (emergence of variants, possibility of reinfection, duration of vaccine protection, etc.).

Sustainable financing for FP in Asia Pacific

Policy brief on sustainable financing for FP in Mongolia

Este trabalho tem como objetivo analisar as metodologias utilizadas na composição de pesquisas com a temática “migração internacional”. A partir da análise, busca-se apresentar as discussões que acompanham os trabalhos de cunho internacional, assim como reunir os meios escolhidos por estes pesquisadores para obtenção e validação de dados e a forma como delimitaram o objeto de pesquisa apesar das dificuldades metodológicas. E, por fim, propõe uma discussão comparando as metodologias utilizadas pelos autores selecionados. Este estudo parte da análise bibliográfica de pesquisas sobre brasileiros e mexicanos nos Estados Unidos, assim como brasileiros em Portugal.

Background Policy makers require information on costs related to inpatient and outpatient health services to inform resource allocation decisions. Methods Country data sets were gathered in 2008–2010 through literature reviews, website searches and a public call for cost data. Multivariate regression analysis was used to explore the determinants of variability in unit costs using data from 30 countries. Two models were designed, with the inpatient and outpatient models drawing upon 3407 and 9028 observations respectively. Cost estimates are produced at country and regional level, with 95% confidence intervals. Results Inpatient costs across 30 countries are significantly associated with the type of hospital, ownership, as well as bed occupancy rate, average length of stay, and total number of inpatient admissions. Changes in outpatient costs are significantly associated with location, facility ownership and the level of care, as well as to the number of outpatient visits and visits per provider per day. Conclusions These updated WHO-CHOICE service delivery unit costs are statistically robust and may be used by analysts as inputs for economic analysis. The models can predict country-specific unit costs at different capacity levels and in different settings. Electronic supplementary material The online version of this article (10.1186/s12962-018-0095-x) contains supplementary material, which is available to authorized users.

Summary Substantial changes are needed to achieve a more targeted and strategic approach to investment in the response to the HIV/AIDS epidemic that will yield long-term dividends. Until now, advocacy for resources has been done on the basis of a commodity approach that encouraged scaling up of numerous strategies in parallel, irrespective of their relative effects. We propose a strategic investment framework that is intended to support better management of national and international HIV/AIDS responses than exists with the present system. Our framework incorporates major efficiency gains through community mobilisation, synergies between programme elements, and benefits of the extension of antiretroviral therapy for prevention of HIV transmission. It proposes three categories of investment, consisting of six basic programmatic activities, interventions that create an enabling environment to achieve maximum effectiveness, and programmatic efforts in other health and development sectors related to HIV/AIDS. The yearly cost of achievement of universal access to HIV prevention, treatment, care, and support by 2015 is estimated at no less than US$22 billion. Implementation of the new investment framework would avert 12·2 million new HIV infections and 7·4 million deaths from AIDS between 2011 and 2020 compared with continuation of present approaches, and result in 29·4 million life-years gained. The framework is cost effective at $1060 per life-year gained, and the additional investment proposed would be largely offset from savings in treatment costs alone.

There is extensive debate in the literature about the practical significance of ex ante moral hazard in health insurance markets. This paper uses data from the U.S. Panel Study of Income Dynamics (1999–2003) to estimate a structural model of individual choice of insurance coverage and four lifestyle decisions: heavy smoking, heavy drinking, lack of exercise and obesity. The results show that health insurance has significant incentive effects on lifestyle choices, increasing the propensity to heavy smoking, lack of exercise and obesity and decreasing the propensity to heavy drinking. There is also significant correlation between the errors of each equation. The results might have implications for the design of health financing policies. The Geneva Papers (2008) 33, 627–644. doi:10.1057/gpp.2008.27

The epidemiological burden of chronic diseases is increasing worldwide and there is very little empirical evidence regarding the economic impact of chronic diseases on individuals and households. The primary objective of this paper is to explore the evidence on how chronic diseases affect household healthcare expenditure, non-health consumption, labour (earned) income, and to demonstrate how transfers may provide some insurance against shocks from chronic diseases. We have explicated a two-part Heckit model on household level data obtained from the Living Standard Measurement Surveys (LSMS) from Russia to control for nontrivial proportion of zeros in the dependent variables, skewed distribution of expenditure data and endogeneity. The results indicate that chronic diseases are significantly associated with higher levels of household healthcare expenditure in Russia and productivity losses reflected by reduced labour supply and reduced household labour income. Non-healthcare expenditure also increased. Results suggest that households are able to insure non-health consumption against chronic diseases, possibly from transfers, which also increased. In addition, socioeconomic status indicators significantly explained the impact of chronic diseases on households. Insurance and higher average education in households were associated with higher healthcare expenditure. Household transfers were significant in Russia despite an appreciable level of insurance cover. We conclude that households depend on informal coping mechanisms in the face of chronic diseases, irrespective of insurance cover. These results have implications for policies regarding the financing of treatment and control of chronic diseases in the country studied.

This study provides estimates of the macroeconomic impact of non-communicable diseases (NCDs) in China and India for the period 2012–2030. Our estimates are derived using the World Health Organization’s EPIC model of economic growth, which focuses on the negative effects of NCDs on labor supply and capital accumulation. We present results for the five main NCDs (cardiovascular disease, cancer, chronic respiratory disease, diabetes, and mental health). Our undiscounted estimates indicate that the cost of the five main NCDs will total USD 23.03 trillion for China and USD 4.58 trillion for India (in 2010 USD). For both countries, the most costly domain is cardiovascular disease. Our analyses also reveal that the costs are much larger in China than in India mainly because of China’s higher and steeper income trajectory, and to a lesser extent its older population. Rough calculations also indicate that WHO’s best buys for addressing the challenge of NCDs are highly cost-beneficial.

This paper provides estimates of the economic impact of non-communicable diseases (NCDs) in China and India for the period 2012-2030. Our estimates are derived using WHO's EPIC model of economic growth, which focuses on the negative effects of NCDs on labor supply and capital accumulation. We present results for the five main NCDs (cardiovascular disease, cancer, chronic respiratory disease, diabetes, and mental health). Our undiscounted estimates indicate that the cost of the five main NCDs will total USD 27.8 trillion for China and USD 6.2 trillion for India (in 2010 USD). For both countries, the most costly domains are cardiovascular disease and mental health, followed by respiratory disease. Our analyses also reveal that the costs are much larger in China than in India mainly because of China's higher income and older population. Rough calculations also indicate that WHO's Best Buys for addressing the challenge of NCDs are highly cost-beneficial.

Strengthening public health, that is, improving the health of whole populations through action across all relevant sectors is at the heart of the World Bank's mission. This policy note takes stock of the global progress in public health over the past decade; lays out the challenges that must be addressed for this progress to be sustained and accelerated; and proposes an approach for the Bank to maximize its contribution to public health in the years ahead. This note comes at a critical juncture, given the important gains made in public health over the past decade. Key global indicators, including life expectancy at birth, under-five mortality and maternal mortality, have shown steady improvement, while initiatives such as the scale-up of polio vaccination and the distribution of bed nets to combat malaria have saved millions of lives. The Bank is proud to have worked with countries and development partners to contribute to these achievements. The note emphasizes that the Bank will need to root its future public health efforts in its areas of comparative advantage, including its capacity to analyze the economic and development impact of health investments, and its extensive experience in working across sectors for health results. The Bank finances investments in all the sectors that impact health, including education, social protection, infrastructure, water and sanitation and transportation, to name a few, and is well placed to help mobilize such sectors through coordinated, population-based interventions to improve health and accelerate development. Given its analytic capability, the Bank has a potentially critical role to play in focusing finite budgets on the most cost-effective actions, particularly in prevention and health promotion.

Since the beginning of the epidemic sex workers have experienced a heightened burden of HIV across settings, despite their higher levels of HIV protective behaviors (UNAIDS, 2009). Unfairly, sex workers have often been framed as 'vectors of disease' and 'core transmitters' rather than workers and human beings with rights in terms of HIV prevention and beyond. By gaining a deeper understanding of the epidemiologic and broader policy and social context within which sex work is set one begins to quickly gain a sense of the complex backdrop for increased risk to HIV among sex workers. This backdrop includes the critical role of stigma, discrimination and violence faced by sex workers, as well as, the importance of community empowerment and mobilization among sex workers to address these regressive forces. The eight country case studies work to highlight the experiences of diverse populations of and contexts for sex work across settings. Given the limited epidemiologic and intervention evaluation data available among male and transgender sex workers, however, our collaborative team (Johns Hopkins University, or JHU, World Bank, United Nations Population Fund (UNFPA), and Global Network of Sex Work Projects, or NSWP) determined that the systematic review, mathematical modeling and cost-effective analyses would focus on female sex workers. Throughout the process of this analysis as a whole, the participation of sex worker perspectives and sex worker organizations such as NSWP and their regional partners has been critical by providing documents and resources, input and consultation throughout the analytical process.