Making the World Safer and Fairer in Pandemics

Global health has long been characterized by injustice, with certain populations marginalized and made vulnerable by social, economic, and health disparities within and among countries. The pandemic only amplified inequalities. In response to it, the World Health Organization and the United Nations have embarked on transformative normative and financial reforms that could reimagine pandemic prevention, preparedness, and response (PPPR). These reforms include a new strategy to sustainably finance the WHO, a UN political declaration on PPPR, a fundamental revision to the International Health Regulations, and negotiation of a new, legally binding pandemic agreement (popularly called the “Pandemic Treaty”). We revisit the cavernous shortcomings of the global Covid-19 response, explain potentially transformative legal reforms and the ethical values that underpin them, and propose actionable solutions to advance both health and justice

The Global Health Architecture: Governance and International Institutions to Advance Population Health Worldwide

The world’s failed response to COVID-19—characterized by weak health systems, a distrust in science, and vastly inequitable access to global public health goods—provides a historic opportunity to reform the global health architecture, including its legal norms, processes, and institutions. We argue that these reforms should be based on the principles of good governance for health: the right to health, equity, inclusive participation, global solidarity, transparency, and accountability. This Perspective examines the global health architecture—its history, current state, and future. It begins by describing the principles of good governance for health, and then how current global health actors and instruments embody them or fall short. Finally, it examines reforms which are underway, particularly for health emergency preparedness and response (HEPR), and what others are needed to bring the global health architecture more in line with principles of good governance for health. Global health institutions and instruments, including new global health instruments currently being negotiated through the World Health Organization, should be reformed to fully incorporate the principles of good governance for health. Equity should be embedded into the prevention of, preparedness for, response to, and recovery from catastrophic health threats, within and across nations and sectors. Finally, robust and sustainable funding of key institutions, national health systems, and civil society would ensure more effective and just responses to health emergencies, including the daily toll of avoidable death and disease disproportionately experienced by poorer and more marginalized populations. Embracing this reform agenda, guided by principles of good governance for health, could ensure that our institutions and systems can protect and promote the health of all populations everywhere

Financing Reforms to Meet a Pivotal Moment in Global Health

2024 will be the most important moment for global health since the World Health Organization’s founding in 1948, but only if states give major reforms their full political and financial backing. Bold new commitments in disease surveillance, capacity building, and more equitable access to health products cannot be achieved without ample and sustainable funding. In this essay, we discuss major reforms found in the emerging pandemic agreement and reformed International Health Regulations and then explore the significant challenges and opportunities for financing them

Is there a gap between recommended and ‘real world’ practice in the management of depression in young people? A medical file audit of practice

BACKGROUND: Literature has shown that dissemination of guidelines alone is insufficient to ensure that guideline recommendations are incorporated into every day clinical practice. METHODS: We aimed to investigate the gaps between guideline recommendations and clinical practice in the management of young people with depression by undertaking an audit of medical files in a catchment area public mental health service for 15 to 25 year olds in Melbourne, Australia. RESULTS: The results showed that the assessment and recording of depression severity to ensure appropriate treatment planning was not systematic nor consistent; that the majority of young people (74.5%) were prescribed an antidepressant before an adequate trial of psychotherapy was undertaken and that less than 50% were monitored for depression symptom improvement and antidepressant treatment emergent suicide related behaviours (35% and 30% respectively). Encouragingly 92% of first line prescriptions for those aged 18 years or under who were previously antidepressant-naïve was for fluoxetine as recommended. CONCLUSIONS: This research has highlighted the need for targeted strategies to ensure effective implementation. These strategies might include practice system tools that allow for systematic monitoring of depression symptoms and adverse side effects, particularly suicide related behaviours. Additionally, youth specific psychotherapy that incorporates the most effective components for this age group, delivered in a youth friendly way would likely aid effective implementation of guideline recommendations for engagement in an adequate trial of psychotherapy before medication is initiated

Is there a gap between recommended and ‘real world’ practice in the management of depression in young people? : a medical file audit of practice

Background: Literature has shown that dissemination of guidelines alone is insufficient to ensure that guideline recommendations are incorporated into every day clinical practice. Methods: We aimed to investigate the gaps between guideline recommendations and clinical practice in the management of young people with depression by undertaking an audit of medical files in a catchment area public mental health service for 15 to 25 year olds in Melbourne, Australia. Results: The results showed that the assessment and recording of depression severity to ensure appropriate treatment planning was not systematic nor consistent; that the majority of young people (74.5%) were prescribed an antidepressant before an adequate trial of psychotherapy was undertaken and that less than 50% were monitored for depression symptom improvement and antidepressant treatment emergent suicide related behaviours (35% and 30% respectively). Encouragingly 92% of first line prescriptions for those aged 18 years or under who were previously antidepressant-naïve was for fluoxetine as recommended. Conclusions: This research has highlighted the need for targeted strategies to ensure effective implementation. These strategies might include practice system tools that allow for systematic monitoring of depression symptoms and adverse side effects, particularly suicide related behaviours. Additionally, youth specific psychotherapy that incorporates the most effective components for this age group, delivered in a youth friendly way would likely aid effective implementation of guideline recommendations for engagement in an adequate trial of psychotherapy before medication is initiated

Findings of the Third Workshop on Neural Generation and Translation

This document describes the findings of the Third Workshop on Neural Generation and Translation, held in concert with the annual conference of the Empirical Methods in Natural Language Processing (EMNLP 2019). First, we summarize the research trends of papers presented in the proceedings. Second, we describe the results of the two shared tasks 1) efficient neural machine translation (NMT) where participants were tasked with creating NMT systems that are both accurate and efficient, and 2) document-level generation and translation (DGT) where participants were tasked with developing systems that generate summaries from structured data, potentially with assistance from text in another language.Comment: Fixed the metadata (author list

The Global Health and Care Worker Compact: Evidence Base and Policy Considerations

Background During the COVID-19 pandemic, and recognising the sacrifice of health and care workers alongside discrimination, violence, poor working conditions and other violations of their rights, health and safety, in 2021 the World Health Assembly requested WHO to develop a global health and care worker compact, building on existing normative documentation, to provide guidance to ‘protect health and care workers and safeguard their rights’. Methods A review of existing international law and other normative documents was conducted. We manually searched five main sets of international instruments: (1) International Labour Organization conventions and recommendations; (2) WHO documents; (3) United Nations (UN) human rights treaties and related documents; (4) UN Security Council and General Assembly resolutions and (5) the Geneva Conventions and Additional Protocols. We included only legal or other normative documents with a global or regional focus directly addressing or relevant to health and care workers or workers overall. Results More than 70 documents met our search criteria. Collectively, they fell into four domains, within which we identified 10 distinct areas: (1) preventing harm, encompassing (A) occupational hazards, (B) violence and harassment and (C) attacks in situations of fragility, conflict and violence; (2) inclusivity, encompassing (A) non-discrimination and equality; (3) providing support, encompassing (A) fair and equitable remuneration, (B) social protection and (C) enabling work environments and (4) safeguarding rights, encompassing (A) freedom of association and collective bargaining and (B) whistle-blower protections and freedom from retaliation. Discussion A robust legal and policy framework exists for supporting health and care workers and safeguarding their rights. Specific human rights, the right to health overall, and other binding and non-binding legal documents provide firm grounding for the compact. However, these existing commitments are not being fully met. Implementing the compact will require more effective governance mechanisms and new policies, in partnership with health and care workers themselves

High temperature piezoelectric properties of flux-grown α-GeO 2 single crystal

International audienceThe temperature-dependence of the piezoelectric properties of trigonal -GeO2 single-crystals obtained by the high-temperature flux method was measured by the resonance technique of the electrical impedance in the 20°C-600°C range. To approach the values of the two independent piezoelectric coefficients d11 and d14, we first measured as a function of temperature the elastic coefficients S11, S14 and S66 and the dielectric permittivity 11 which are involved in the coupling coefficient k of both the thickness shear mode and the transverse mode. A Y-cut plate with a simple +45°-rotation ((YXtwl) +45°/0°/0°) was used to measure the coupling coefficient of the thickness shear mode, and two X-turned plates ((XYtwl) +45°/0°/0° and (XYtwl)-45°/0°/0°) were prepared to characterize the coupling coefficient of two transverse modes. From the whole experimental measurements, the piezoelectric coefficients of -GeO2 were calculated up to 600 °C. They show that this crystal is one of the most efficient in regard of the -quartz-like family at room temperature, and that its thermal comportment retains large piezoelectric properties up to 600°C