The use of imagery in global health: an analysis of infectious disease documents and a framework to guide practice

Esmita Charani, PhD †
Sameed Shariq, BSc †
Alexandra M Cardoso Pinto, BSc
Raabia Farooqi, BSc
Winnie Nambatya, MPharm
Oluchi Mbamalu, PhD
Seye Abimbola, PhD
Marc Mendelson, PhD

The Lancet | Open Access | Published: December 01, 2022 | DOI:https://doi.org/10.1016/S2214-109X(22)00465-X

Summary


We report an empirical analysis of the use of imagery by the key actors in global health who set policy and strategy, and we provide a comprehensive overview, particularly related to images used in reports on vaccination and antimicrobial resistance. The narrative currently depicted in imagery is one of power imbalances, depicting women and children from low-income and middle-income countries (LMICs) with less dignity, respect, and power than those from high-income countries. The absence of any evidence of consent for using intrusive and out-of-context images, particularly of children in LMICs, is concerning. The framework we have developed provides a platform for global health actors to redefine their intentions and recommission appropriate images that are relevant to the topic, respect the integrity of all individuals depicted, are accompanied by evidence of consent, and are equitable in representation. Adhering to these standards will help to avoid inherent biases that lead to insensitive content and misrepresentation, stigmatisation, and racial stereotyping.

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How the World Bank weakens health systems

Health researchers Natalie Rhodes and Remco van de Pas discuss about the nature and limitations of the World Bank Pandemic Prevention, Preparedness and Response fund.

Peoples Dispatch | October 31, 2022

Natalie Rhodes, PhD candidate at University of Leeds, and People’s Health Movement, along with Remco van de Pas, researcher at the Centre for Planetary Health Policy, and People’s Health Movement discuss in detail about the implications of the newly established World Bank fund for Pandemic Prevention, Preparedness and Response and the Bank’s other policies pertaining to public health.

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The health status of Indonesia’s provinces: the double burden of diseases and inequality gap

Vicka Oktaria and Yodi Mahendradhata

The Lancet | Open Access | Published: November, 2022 | DOI:https://doi.org/10.1016/S2214-109X(22)00405-3

In The Lancet Global Health, the Global Burden of Disease Study (GBD) 2019 Indonesia Collaborators report on 30 years of disease burden and risk factors in Indonesia, expanding their analysis to a more granular subnational level.

1

 Given the ongoing challenges of obtaining comparable subnational data, the GBD data provides enlightening evidence for decision makers at the subnational level for future programmatic planning and policy strategies specific to their local health issues. These findings will ultimately help narrow down the inequality gaps at regional levels. This paper is perfectly timed to captured and illustrate the health status in Indonesia before and after the launch of the universal health coverage (UHC) programme Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) in 2014. The BPJS has now covered more than 75% of the Indonesian population.

2

Although excellent programmatic interventions and policies have significantly reduced the disease burden in the past three decades, communicable diseases remain the main source of disability-adjusted life-years (DALYs) in Indonesia, along with the rising burden of non-communicable diseases (NCDs) such as diabetes. Diabetes has become one of the main priorities of the national government as programmatic research and efforts towards prevention, early detection, and treatment of diabetes are increasing. Apart from poor quality of life, health-care costs related to diabetes complications are high, with diabetic retinopathy accounting for nearly 2% of the total national state budget, and are estimated to triple by 2025.

3

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Drug-resistant typhoid ‘spreading out of South Asia’

Sanjeet Bagcchi

SciDevNet | June 29, 2022

[NEW DELHI] Antibiotic-resistant strains of Salmonella Typhi, the typhoid bacteria, have spread from South Asia to other countries nearly 200 times since 1990, new research suggests.

Every year, an estimated 11 to 20 million people suffer from typhoid and 128,000 to 161,000 victims die from the diseasesays the World Health Organization (WHO). Typhoid spreads through water contaminated by an infected person’s faeces. Its symptoms include prolonged fever, nausea, rashes, headache and diarrhoea or constipation.

S. Typhi can only infect humans, and by studying how closely related bacteria found in different places are, we discovered that typhoid had spread from South Asia, the home of typhoid, to many parts of the world many times,” says Gagandeep Kang, co-author of the study and professor at the Wellcome Trust Research Laboratory in the Division of Gastrointestinal Sciences at the Christian Medical College, Vellore, India.

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Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019

GBD 2019 Adolescent Transport and Unintentional Injuries Collaborators

The Lancet | Open Access | Published: June 29, 2022 | DOI: https://doi.org/10.1016/S2468-2667(22)00134-7

Summary
Background
Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades.

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PURPOSe study: understanding the burden of stillbirths in south Asia

Joao Paulo Souza & Rajiv Bahl

The Lancet | Open Access | Published: July, 2022 | DOI:https://doi.org/10.1016/S2214-109X(22)00218-2

Stillbirth prevention is a global health priority and a crucial step towards better maternal and newborn health and wellbeing.1 In 2019, 2 million babies were stillborn, with over three-quarters of these stillbirths occurring in sub-Saharan Africa and south Asia.2 However, progress has been slow, and unless there is a substantial acceleration in progress, the Sustainable Development Goal target 3.2 and Every Newborn Action Plan target of 12 stillbirths per 1000 births will not be met by 2030.3 Slow progress is partly due to the limited emphasis on stillbirth reduction in maternal and child health programmes and a paucity of accurate, complete, and actionable information on stillbirths, particularly in high-burden areas.1, 4

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Do hospital facilities influence global cancer surgery outcomes?

Deo Suryanarayana & Prashant Gupta

The Lancet | Open Access | Published: May 24, 2022 | DOI:https://doi.org/10.1016/S2214-109X(22)00214-5

Cancer is emerging worldwide as a significant public health problem and trends indicate that low-income and middle-income countries (LMICs) are going to witness a substantial increase in cancer burden by 2040.1 Surgery plays a vital role in the management of solid tumours, but only 25% of the global population has access to safe, affordable, and timely surgery.2 This disparity is more pronounced in LMICs dealing with high cancer burden and limited resources. Timely access to quality multidisciplinary care is a critical factor determining outcomes. Surgical outcomes are reliant on the experience and skills of the surgeon, and the availability of ancillary support facilities. Cancer surgery outcomes have improved during the past three decades, primarily because of the advancements made in surgery, anaesthesia, surgical technology, perioperative, and critical care domains.3  4 Operative mortality in patients receiving complex cancer surgeries such as Whipple’s resection and oesophagectomy has reduced drastically.5 However, most of these studies originate from tertiary care cancer centres in high-income countries, and there is little literature available related to cancer surgical outcomes from LMICs.

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WTO decides: no TRIPS waiver

Trade delegates and WTO Secretariat celebrate package of documents issued at the end of the Ministerial Conference, yet outlook for Global South remains bleak

Peoples Health Dispatch | June 17, 2022

Activists stage a “die-in” action at the WTO Ministerial Conference to protest the lack of TRIPS waiver (Photo: Our World is Not for Sale

The WTO announced on June 17 that it had reached an agreement on the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) waiver. The deal has been criticized by people’s movements around the world as the WTO decidedly rejected the demand by health activists for a full TRIPS waiver.

The ministerial decision on the TRIPS agreement, spurred by the COVID-19 pandemic, was announced in the early morning in Geneva on June 17, almost two days after the expected end of the 12th Ministerial Conference. Although the decision was hailed by the WTO Secretariat and officials from the Global North as an unprecedented result, in practice it falls short of meeting the bare minimum of the world’s needs.

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Guardians of the brain: how a special immune system protects our grey matter

The nervous and immune systems are tightly intertwined. Deciphering their chatter might help address many brain disorders and diseases.

Diana Kwon

Nature | June 01, 2022

The brain’s immune system includes a network of transport vessels (blue) and its own immune cells made in the bone marrow (green). Credit: Siling Du, Kipnis lab, Washington University in St. Louis

The brain is the body’s sovereign, and receives protection in keeping with its high status. Its cells are long-lived and shelter inside a fearsome fortification called the blood–brain barrier. For a long time, scientists thought that the brain was completely cut off from the chaos of the rest of the body — especially its eager defence system, a mass of immune cells that battle infections and whose actions could threaten a ruler caught in the crossfire.

In the past decade, however, scientists have discovered that the job of protecting the brain isn’t as straightforward as they thought. They’ve learnt that its fortifications have gateways and gaps, and that its borders are bustling with active immune cells.

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Universal health coverage and incarceration

Tyler N A Winkelman, MD, Kayla C Dasrath, MD, Jesse T Young, PhD & Stuart A Kinner, PhD

The Lancet | Open Access | Published: June, 2022 | DOI:https://doi.org/10.1016/S2468-2667(22)00113-X

Summary
Global progress towards universal coverage of essential health services, a component of UN Sustainable Development Goal (SDG) 3.8, is measured at the country level using the WHO Service Coverage Index. However, data collection for this crucial metric excludes prisons and youth detention centres, despite the health needs in these settings, chronic underinvestment in custodial health care, and poor health outcomes for people released from custody in most countries. Particularly in countries with high incarceration rates, failure to include custodial settings in calculations of the service coverage index might result in overestimation of progress towards SDG 3.8.1, and mask important health inequalities. In this Viewpoint, we explore how failure to consider custodial settings in calculation of the service coverage index contributes to health inequalities and impedes progress towards SDG 3. We recommend explicitly considering all custodial settings in future estimates of progress towards universal health coverage.

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