The Value Proposition of the Global Health Security Index

Infectious disease outbreaks pose major threats to human health and security. Countries with robust capacities for preventing, detecting and responding to outbreaks can avert many of the social, political, economic and health system costs of such crises. The Global Health Security Index (GHS Index)—the first comprehensive assessment and benchmarking of health security and related capabilities across 195 countries—recently found that no country is sufficiently prepared for epidemics or pandemics. The GHS Index can help health security stakeholders identify areas of weakness, as well as opportunities to collaborate across sectors, collectively strengthen health systems and achieve shared public health goals. Some scholars have recently offered constructive critiques of the GHS Index’s approach to scoring and ranking countries; its weighting of select indicators; its emphasis on transparency; its focus on biosecurity and biosafety capacities; and divergence between select country scores and corresponding COVID-19-associated caseloads, morbidity, and mortality. Here, we (1) describe the practical value of the GHS Index; (2) present potential use cases to help policymakers and practitioners maximise the utility of the tool; (3) discuss the importance of scoring and ranking; (4) describe the robust methodology underpinning country scores and ranks; (5) highlight the GHS Index’s emphasis on transparency and (6) articulate caveats for users wishing to use GHS Index data in health security research, policymaking and practice

Improved tools and strategies for the prevention and control of arboviral diseases: A research-to-policy forum

Background Research has been conducted on interventions to control dengue transmission and respond to outbreaks. A summary of the available evidence will help inform disease control policy decisions and research directions, both for dengue and, more broadly, for all Aedes-borne arboviral diseases. Method A research-to-policy forum was convened by TDR, the Special Programme for Research and Training in Tropical Diseases, with researchers and representatives from ministries of health, in order to review research findings and discuss their implications for policy and research. Results The participants reviewed findings of research supported by TDR and others. Surveillance and early outbreak warning. Systematic reviews and country studies identify the critical characteristics that an alert system should have to document trends reliably and trigger timely responses (i.e., early enough to prevent the epidemic spread of the virus) to dengue outbreaks. A range of variables that, according to the literature, either indicate risk of forthcoming dengue transmission or predict dengue outbreaks were tested and some of them could be successfully applied in an Early Warning and Response System (EWARS). Entomological surveillance and vector management. A summary of the published literature shows that controlling Aedes vectors requires complex interventions and points to the need for more rigorous, standardised study designs, with disease reduction as the primary outcome to be measured. House screening and targeted vector interventions are promising vector management approaches. Sampling vector populations, both for surveillance purposes and evaluation of control activities, is usually conducted in an unsystematic way, limiting the potentials of entomological surveillance for outbreak prediction. Combining outbreak alert and improved approaches of vector management will help to overcome the present uncertainties about major risk groups or areas where outbreak response should be initiated and where resources for vector management should be allocated during the interepidemic period. Conclusions The Forum concluded that the evidence collected can inform policy decisions, but also that important research gaps have yet to be filled

All Hands on Deck: A synchronized whole-of-world approach for COVID-19 mitigation.

The COVID-19 pandemic can no longer be mitigated by a nationwide approach of individual nations alone. Given its scale and accelerating expansion, COVID-19 requires a coordinated and simultaneous Whole- of-World approach that galvanizes clear global leadership and solidarity from all governments of the world. Considering an 'all hands-on deck' concept, we present a comprehensive list of tools and entities responsible for enabling them, as well a conceptual framework to achieve the maximum impact. The list is drawn from pandemic mitigation tools developed in response to past outbreaks including influenza, coronaviruses, and Ebola, and includes tools to minimize transmission in various settings including person-to-person, crowd, funerals, travel, workplace, and events and gatherings including business, social and religious venues. Included are the roles of individuals, communities, government and other sectors such as school systems, health, institutions, and business. While individuals and communities have significant responsibilities to prevent person-to-person transmission, other entities can play a significant role to enable individuals and communities to make use of the tools. Historic and current data indicate the role of political will, whole-of-government approach, and the role of early introduction of mitigation measures. There is also an urgent need to further elucidate the immunologic mechanisms underlying the epidemiological characteristics such as the low disease burden among women, and the role of COVID-19 in inducing Kawasaki-like syndromes in children. Understanding the role of and development of anti-inflammatory strategies based on our understanding of pro-inflammatory cytokines (IL1, IL-6) is also critical. Similarly, the role of oxygen therapy as an anti-inflammatory strategy is evident and access to oxygen therapy should be prioritized to avoid the aggravation of COVID-19 infection. We highlight the need for global solidarity to share both mitigation commodities and infrastructure between countries. Given the global reach of COVID-19 and potential for repeat waves of outbreaks, we call on all countries and communities to act synergistically and emphasize the need for synchronized pan-global mitigation efforts to minimize everyone's risk, to maximize collaboration, and to commit to shared progress

Una visión panorámica de las experiencias de telesalud en Perú

This article presents the main experiences of telehealth conducted in Peru between 2002 and 2010. It analyzes information from published literature and unpublished documents about experiences of public and private Telehealth. From this information, 26 experts were consulted about the characteristics of the identified Telehealth experiences. A database of 38 experiences, which are described and analyzed in this publication was produced. Reflections and recommendations are presented to expand the use of Telehealth in Peru.El artículo presenta las principales experiencias de Telesalud realizadas en el Perú entre los años 2002 al 2010. Analiza información de literatura publicada y documentos no publicados acerca de experiencias de Telesalud públicas y privadas. A partir de esta información se consultó con 26 expertos acerca de las características de las experiencias de Telesalud identificadas. Se generó una base de datos de 38 experiencias, que se describen y analizan en esta publicación. Se presenta reflexiones y recomendaciones para ampliar el uso de la Telesalud en el Perú

Una visión panorámica de las experiencias de Telesalud en Perú

El artículo presenta las principales experiencias de telesalud realizadas en el Perú entre los años 2002 al 2010. Analiza información de literatura publicada y documentos no publicados acerca de experiencias de telesalud públicas y privadas. A partir de esta información se consultó con 26 expertos acerca de las características de las experiencias de telesalud identificadas. Se generó una base de datos de 38 experiencias, que se describen y analizan en esta publicación. Se presenta reflexiones y recomendaciones para ampliar el uso de la telesalud en el Per

Acceso y uso de las tecnologías de información y comunicación y percepciones hacia un sistema informático para mejorar la adherencia al tratamiento, en médicos endocrinólogos de un hospital público de Perú.

Objetivos: Describir el acceso y uso de las tecnologías de información y comunicación (TIC) de parte de médicos endocrinólogos de un hospital público de Lima; y describir las percepciones de los médicos hacia un sistema informático para mejorar la adherencia al tratamiento en pacientes con diabetes (CareNet). Material y métodos: Estudio descriptivo y transversal. Se aplicó una encuesta previamente validada a médicos endocrinólogos de un hospital público del Perú con el fin de evaluar el acceso, uso y percepciones hacia las TIC. Además, se evalúo la percepción de los médicos hacia un sistema informático. Resultados: De un total de ocho médicos que trabajan en el servicio de endocrinología, siete médicos respondieron la encuesta (mediana de edad: 36 años, 57,1% hombres) todos usuarios de celulares y mensajes de texto corto, correo electrónico y la Internet en frecuencia diaria. Todos los médicos respondieron que se sentían cómodos/muy cómodos con el uso de las computadoras. Todos consideraron que el sistema informático podría ser útil en la mejora de la adherencia al tratamiento de los pacientes con diabetes. Todos los médicos estuvieron de acuerdo/completamente de acuerdo que es fácil aprender a utilizar el sistema informático. Todos consideraron que la capacitación que se les brindó del sistema CareNet fue bueno/excelente. Conclusión: La mayoría de los médicos endocrinólogos reportaron una percepción positiva hacia el uso de las TIC en su práctica clínica y hacia el sistema CareNet, en particular, refiriendo que es fácil de utilizar. (Rev Med Hered 2011;22:15-22)

¿Quién es la víctima y quién el agresor en la violencia física entre parejas?: estudio epidemiológico en siete ciudades del Perú Who is the victim and who the offender in intimate partner physical violence?: an epidemiological study in seven cities of Peru

Objetivos. Identificar factores asociados con la probabilidad de ser víctima o agresor en violencia física entre parejas. Materiales y métodos. Se analizó la base de datos de una encuesta poblacional aplicada en siete ciudades de Perú (Lima, Arequipa, Huamanga, Trujillo, Cusco, Callao y Maynas). Participaron 6399 hombres y mujeres, de los cuales 3909 refirieron vivir en pareja al momento de la entrevista. Se empleó regresión logística univariada y multivariada para identificar factores asociados con cualquiera de los roles, víctima o agresor. El alfa establecido fue 0,01. Resultados. La probabilidad de ser víctima o agresor en la violencia física entre parejas fue similar para ambos sexos (p>0,01), e independiente del tiempo de convivencia. La exposición a la violencia en la niñez, tener una actitud favorable a la violencia, ser menor de 45 años, el consumo excesivo de alcohol, tener educación superior incompleta y tener un ingreso familiar de menos de 750 USD son factores asociados tanto a ser víctima como a ser agresor. Geográficamente, Cusco es la ciudad en que se puede encontrar con mayor probabilidad personas que ejercen violencia física contra la pareja o son víctimas de ella. El valor fue pObjectives. To identify factors associated to the probability of being the aggressor or the victim in cases of intimate partner physical violence. Materials and methods. A secondary data analysis was performed to an epidemiological survey done in seven cities in Peru (Lima, Arequipa, Huamanga, Trujillo, Cuzco, Callao and Maynas). 6399 men and women participated, of whom 3909 participants declared living together with an intimate partner at the time of the interview. Univariate and multivariate logistic regression models were used to identify associated factors to the roles of victim or aggressor. Results. The likelihood of being aggressor or victim in cases of intimate partner physical violence was independent of sex (p<0,01) and the couple´s time living together. Factors associated to a higher probability of both roles included a history of exposure to physical violence during childhood, having a favorable attitude towards violence, heavy alcohol drinking, and being younger than 45 years, as well as having a monthly family income of less than 750 USD or an educational attainment of less than complete tertiary school. Geographically, Cusco was the city where it was most likely to find an aggressor or a victim of intimate partner physical violence. Most of these associations obtained p-values of less than 0.001. Conclusions. In cases of intimate partner physical violence, the pattern of predictors is similar in both roles, i.e., aggressor and victim. Sex and the couple´s span of time living together did not predict any of both roles