Monday, February 13, 2012

[EQ] Ethical tensions in dealing with noncommunicable diseases globally

Ethical tensions in dealing with noncommunicable diseases globally

Sridhar Venkatapuram a Martin McKee a & David Stuckler b

a London School of Hygiene and Tropical Medicine, London, England.

b Department of Sociology, University of Cambridge, England.

Bulletin of the World Health Organization
Online First -Published online: 3 February 2012

Available online at: http://bit.ly/zGC2jk

“…..Noncommunicable diseases pose an increasingly high burden of disease that threatens economic and social development, yet cost-effective health interventions exist. World leaders recognized the compelling case for action with the declaration at the United Nations high-level meeting on noncommunicable diseases in September 2011.1,2

Since that meeting, the World Health Organization (WHO) has been developing a Global Monitoring Framework and the United Nations Secretary-General is preparing to report to the 67th session of the General Assembly in September 2012 on ways to tackle noncommunicable diseases across different sectors.


This paper aims to inform these debates by reviewing the declarations that resulted from WHO regional meetings held in preparation for last September’s high-level meeting (Table 1). We identified four “ethical tensions” that must be resolved. These tensions are not exhaustive or mutually exclusive but provide a framework for debate.

Human rights approaches
‘…Effective action on noncommunicable diseases involves addressing multiple human rights, such as the right to information to make informed choices about diet and activity (e.g. food labels that people can understand), the right to bodily integrity (e.g. freedom from exposure to second-hand smoke); and the right to health (including access to essential medicines). These human rights may conflict with corporate rights, such as the right of pharmaceutical companies to exploit patents or express freedom of speech (through marketing)….”


Social determinants

“….Political leaders face difficult decisions about where to invest resources along the causal chain of disease. They must care for those already ill but also tackle the underlying causes of the diseases….”

Funding

“…Governments must balance the needs of their own citizens with their obligations to provide aid to other countries. There is a glaring global inequality in the burden of noncommunicable diseases and in the domestic resources available to address them….”

Which diseases?

“….All governments must set priorities for action, such as whether to focus on interventions for those people in most need, those who would benefit most or on actions that would benefit the most people. The high-level meeting initially prioritized four diseases (cardiovascular disease, cancer, chronic lung diseases and diabetes) with high mortality burdens and four risk factors (tobacco use, poor diet, harmful use of alcohol and physical inactivity)…..”

 


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[EQ] LSE Conference: Towards a global health policy?

Conference: Towards a global health policy?


Celebrating 25 years of health policy research and teaching at the LSE

19-20 March 2012, London School of Economics and Political Science, UK

Website: http://bit.ly/zapCqV

Themes include:


Access to drugs – the number one policy issue?
Chair Mary Baker MBE, President, European Brain Council


The global health workforce – how can we get it right?

Chair Martin McKee CBE, Professor of European Public Health, LSHTM

Speakers Gilles Dussault, Professor, Institute of Hygiene and Tropical Medicine, Lisbon

Armin Fidler, Lead Health Policy Adviser, World Bank (to be confirmed)


Does high-performing health system mean the same thing everywhere?

Chair Josep Figueras, Director, European Observatory on Health Systems and Policies

Speakers Michael Borowitz, Senior Health Specialist, OECD

Joe Kutzin, Co-ordinator, Health Financing Policy, WHO Geneva


Protecting health in difficult circumstances – politics, economics and health

Chair Anne Mills CBE, Vice Director & Professor of Health Economics and Policy, LSHTM

Speakers Di McIntyre, Research Chair in ‘Health and Wealth’, University of Cape Town

Elias Mossialos, Brian Abel-Smith Professor of Health Policy, LSE

Yogesh Rajkotia, Director, Institute for Collaborative Development

Bayard Roberts, Lecturer in Public Health, LSHTM

 

 


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[EQ] Evidence summaries: the evolution of a rapid review approach

Evidence summaries: the evolution of a rapid review approach

Sara Khangura1, Kristin Konnyu2, Rob Cushman3, Jeremy Grimshaw1,4, David Moher2,4

1Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada

2Clinical Epidemiology Program, Ottawa Hospital Research Institute,  Ottawa, Ontario,Canada

3Champlain Local Health Integration Network, Ottawa, Ontario, Canada

4Epidemiology and Community Medicine, University of Ottawa, Ottawa,Ontario, Canada

Systematic Reviews 2012, 1:10 doi:10.1186/2046-4053-1-10 -  10 February 2012

Available online PDF [22p.] at: http://bit.ly/AgrH4N

“….Rapid reviews have emerged as a streamlined approach to synthesizing evidence - typically for informing emergent decisions faced by decision makers in health care settings. Although there is growing use of rapid review 'methods', and proliferation of rapid review products, there is a dearth of published literature on rapid review methodology.
This paper outlines our experience with rapidly producing, publishing and disseminating evidence summaries in the context of our Knowledge to Action (KTA) research program.


Methods

The Knowledge to Action  KTA research program is a two-year project designed to develop and assess the impact of a regional knowledge infrastructure that supports evidence-informed decision making by regional managers and stakeholders. As part of this program, we have developed evidence summaries - our form of rapid review - which have come to be a flagship component of this project.

 

Our eight-step approach for producing evidence summaries has been developed iteratively, based on evidence (where available), experience and knowledge user feedback. The aim of our evidence summary approach is to deliver quality evidence that is both timely and user-friendly.

Results

From November 2009 to March 2011 we have produced 11 evidence summaries on a diverse range of questions identified by our knowledge users. Topic areas have included questions of clinical effectiveness to questions on health systems and/or health services. Knowledge users have reported evidence summaries to be of high value in informing their decisions and initiatives. We continue to experiment with incorporating more of the established methods of systematic reviews, while maintaining our capacity to deliver a final product in a timely manner.


Conclusions

The evolution of the Knowledge to Action KTA rapid review evidence summaries has been a positive one. We have developed an approach that appears to be addressing a need by knowledge users for timely, user-friendly, and trustworthy evidence and have transparently reported these methods here for the wider rapid review and scientific community….”


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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]
Washington DC USA

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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