2017年-世界发展银行全球_Disease_Control_Priorities_Third_Edition___Volume_6_Major_Infectious_Diseases_509页_137mb

报告摘要

Summary of Major Infectious Diseases from Disease Control Priorities, Third Edition

Core Content

Major Infectious Diseases is one of the nine volumes in the Disease Control Priorities (DCP3) series, published by the World Bank. It provides a comprehensive analysis of the cost-effectiveness and policy implications of interventions for major infectious diseases. The volume emphasizes the importance of integrating interventions into health systems and considers the broader impacts of these diseases on populations, including financial and health outcomes.

Main Themes and Key Messages

Infectious Diseases and Health Burden: Until the late 20th century, infectious diseases were the leading cause of global mortality and disability. Today, while noncommunicable diseases (NCDs) have taken over this role, infectious diseases remain a significant threat, particularly in low- and middle-income countries (LMICs).
Progress in Disease Control: There has been substantial progress in reducing the burden of infectious diseases. For example, HIV/AIDS mortality has declined by 50% since 2004 due to the expansion of antiretroviral therapy. Similarly, mother-to-child transmission of HIV has been reduced to low levels, even in generalized epidemic settings. Malaria, diarrheal diseases, and lower respiratory infections have also seen a decline in mortality.
Technological and Policy Innovations: The volume highlights several technological and policy innovations that have contributed to these improvements, including preexposure prophylaxis (PrEP), new diagnostics, vaccines for cervical cancer and hepatitis C, and community-based interventions.
Cost-Effectiveness and Financial Protection: DCP3 introduces the concept of financial risk protection, which is crucial for ensuring that health interventions do not lead to catastrophic financial burden for individuals and families. Cost-effective interventions, such as condoms for female sex workers or insecticide-treated bednets, are emphasized as critical tools for disease prevention.
Challenges and Future Directions: Despite progress, challenges remain, including the emergence of new pathogens like the Ebola and Zika viruses, and the ongoing threat of drug-resistant infections. The volume also underscores the need for better integration of services, strong community engagement, and targeted interventions to maximize the impact of limited resources.
Global Health Initiatives: The World Health Organization (WHO) has played a key role in global disease control through initiatives like the Global Malaria Action Plan (GMAP) and the Roll Back Malaria (RBM) partnership. The volume also discusses the importance of a "One Health" approach, which recognizes the interconnectedness of human, animal, and environmental health.
Equity in Disease Control: DCP3 emphasizes the importance of equity in disease control, noting that cost-effective interventions are not truly effective if they disproportionately burden the poor. The volume supports the use of public finance and other mechanisms to ensure that health outcomes are distributed equitably across income groups.

Key Interventions and Packages

HIV/AIDS: The volume covers a wide range of interventions, including prevention, treatment, and care. It discusses the effectiveness of treatment as prevention (TasP), the cost-effectiveness of prevention strategies, and the importance of community-based approaches in reducing transmission.
Tuberculosis (TB): The volume addresses the challenges of TB control, including the need for better diagnostics and treatment strategies, as well as the importance of addressing drug resistance.
Malaria: The volume explores both malaria elimination and control strategies, highlighting the importance of vector management, diagnostics, and treatment.
Viral Hepatitis: The volume notes the significant impact of viral hepatitis on global health, emphasizing the need for improved prevention and treatment, particularly for hepatitis B and C, which are both treatable and vaccine-preventable.
Neglected Tropical Diseases (NTDs): DCP3 presents a strong case for investing in the elimination of NTDs, which affect millions in LMICs. The volume also highlights the importance of addressing these diseases through integrated approaches.
Drug-Resistant Infections: The volume discusses the growing threat of antimicrobial resistance and the need for continued innovation in biomedicine and better stewardship of antibiotics.

Conclusion

Major Infectious Diseases is a valuable resource for policymakers, providing evidence-based guidance on how to allocate resources effectively to reduce the burden of infectious diseases. It underscores the importance of cost-effectiveness, financial protection, and community engagement in achieving sustainable and equitable health outcomes. The volume also calls for continued investment in research, innovation, and global health initiatives to address both existing and emerging infectious disease threats.

Key Contributors and Acknowledgments

The volume is edited by King K. Holmes, Stefano Bertozzi, Barry R. Bloom, Prabhat Jha, Hellen Gelband, Lisa M. DeMaria, and Susan Horton. It is supported by the Bill & Melinda Gates Foundation, the InterAcademy Medical Panel, and World Bank Publications. Over 500 individuals and multiple institutions contributed to the development of DCP3.

References

AVERT. 2017. "Prevention of Mother-to-Child Transmission (PMTCT) of HIV."
Parpia, A. S., M. L. Ndeffo-Mbah, N.S. Wenzel, and A. P. Galvani. 2016. "Effects of Response to 2014-2015 Ebola Outbreak on Deaths from Malaria, HIV/AIDS, and Tuberculosis, West Africa."
UNAIDS. 2016. "AIDS by the Numbers."
WHO. 2016. "10 Facts on Malaria."
WHO. 2017. "Tuberculosis: Fact Sheet."