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public health

How antimicrobial resistance (AMR) stewardship is a critical part of strong health systems

Uzo Chukwuma's picture


Under the East Africa Public Health Laboratory Networking Project, diagnostic capacity has been strengthened through the construction of state of the art laboratories. © Miriam Schneidman / World Bank Group 2018


My interest in public health began in childhood and was marked by my experiences growing up in a low-income country with limited public health infrastructure. I felt firsthand the impact of an inadequate public health system when a beloved cousin succumbed to AIDS. My mother suffered a prolonged, resistant infection with complications after invasive surgery, and my family constantly battled malaria due to drug resistance or counterfeit drugs.

Some solutions for improving pedestrian safety

Irene Portabales González's picture
Also available in: Spanish
Road with independent space for pedestrians, cyclists and cars in San Isidro. Photo: World Bank
We all have an intuitive sense that pedestrians are particularly vulnerable to road traffic crashes. After all, there is only so much the human body can take. At 30 km per hour, a pedestrian has a 90% chance to survive an impact. But if a vehicle hits you at 50 km/h while you’re walking down the street, that collision will have the same impact a falling from the fourth floor of a building.

Data from the World Health Organization (WHO) confirms that road crashes do indeed take a serious toll on pedestrians. In 2013, more than 270,000 pedestrians lost their lives globally, representing almost 1/5 of the total number of deaths.

In the United States, numbers from Insurance Institute for Highway Safety reveal a 46% increase in the number of pedestrians dying on the road, largely due to the expansion of rapid arterial roads in urban and suburban areas.

In Peru, where we’re based traffic crashes data pertaining to pedestrians are just as startling. According to the Ministry of Health, almost half of pedestrians involved in a collision sustain multiple injuries, and 22% of them suffer from trauma to the head. The chances of a fatal outcome or other serious consequences are very high.

Getting to zero traffic fatalities: What will it take?

Irene Portabales González's picture
Also available in: Español
Photo: Geraint Rowland
We must stop deaths on the roads. No one would argue with that, of course. But for us who live in Peru and many other developing countries, the importance of making road safety a global development priority really hits home—especially after a string of dramatic crashes that have made headlines across the country.

Last February, a bus fell to the bottom of a 200-metre ravine and left 45 dead in Arequipa, including several children. A month before, the country witnessed its deadliest traffic crash on record when a bus plunged down a cliff in Pasamayo, just north of Lima, killing some 52 people.

According to government data, 89,304 traffic crashes were reported on the Peruvian road network in 2016, with a total of 2,696 fatalities. However, the latter figure only includes deaths occurring within 24 hours of a crash, and does not account for victims who may die from their injuries later on.

The global statistics are equally concerning. The World Health Organization (WHO) shows in its Global status report on road safety 2015 that traffic crashes represent one of the main causes of death globally, and is actually the leading cause for people aged 15 to 29.

Halving road deaths

Pierre Guislain's picture
Road traffic fatalities per 100,000 population
Roads are the dominant means of transportation worldwide. They connect people, communities, and markets together—bringing opportunities to the poor and enabling broad-based economic growth. Yet every year, millions of tragic and preventable deaths and serious injuries result from road safety failings. Although solutions are available and progress has been made, efforts to reduce traffic fatalities remain insufficient, especially in low and middle income countries. Urgent action is needed if we are to achieve the Sustainable Development target 3.6 of cutting the number of road fatalities in half.
 
As things stand, every 30 seconds a person is killed in a road crash. To see how many road deaths there are in your country each year, click here. And that’s not all: for every death in a road crash, there are generally at least 20 times as many injuries.
 
In many countries, school children have to gamble their lives to get an education, crossing against speeding traffic to get to school. Approximately 500 children die every day in road crashes, with many of these deaths occurring when children try to cross the road on their way to and from school. Click here to see Luc Besson’s striking 3-minute film on this situation.
 
Over 90% of road fatalities and injuries occur in low and middle income countries. Rapid motorization in developing countries, when it takes place without effective road safety management and infrastructure, contributes to the epidemic of road deaths.

Running away from “Tobacco Road”

Patricio V. Marquez's picture
Image: Patricio Marquez

Earlier this fall, my oldest son invited me to watch him run his first half marathon in Durham, North Carolina. While standing at the starting line, facing hundreds of runners of different ages, I could not help but be amazed by the irony of the situation:  In the midst of a region in the United States known as “tobacco road,” there was tangible evidence of a significant, healthier turn in people’s norms and behaviors.

In the Caribbean, close encounters of a public health kind

Carmen Carpio's picture
Sick Caribbean Map
Illustration: Carmen Carpio and Sabrina Grace Moren

I consider myself a pretty lucky person.  I often work across the beautiful islands of the Caribbean, with their glistening turquoise seas, the lush greenery, fresh tropical fruit… I could go on, but I think you get the idea. Paradise is not always perfect, however: Beneath the postcard views is an often not-so-perfect public health system.

A recent “close encounter” in the Caribbean served as a stark reminder of this truth. Different from the movie “Close Encounters of the Third Kind”, it didn’t involve little green men nor giant floating spaceships, but something just as unknown, at least to me: chikungunya, a viral disease transmitted by the bite of infected mosquitoes.

 
Unfortunately, I was infected with chikungunya a little over a year ago during a work trip to the Eastern Caribbean in support a results-based financing project for the health sector.  Our team was de-briefing near the ocean when it happened: I felt a quick sting from a mosquito bite, but didn’t think much of it.  I felt unusually tired that evening, and by the next morning a number of other symptoms appeared – it was indeed chikungunya.

Vaccines Save Lives!

Patricio V. Marquez's picture
photo (c) GAVI: The Vaccine Alliance

Measles cases in U.S. highlight need to eliminate vaccine-preventable diseases everywhere

The news media in the United States and abroad has been abuzz in recent days focusing on the measles outbreak at Disneyland.  The irony of this situation is that measles, after being officially eliminated in the United States in 2000, reappeared in 2014 with 644 cases in 27 states as reported by the US Centers for Disease Control and Prevention (US CDC).  The reason is simple:  while in the 1980s, more than 97% of one-year olds in the United States were routinely vaccinated, the current share has fallen to 91%, facilitated by exemptions in some states that permit parents to “opt out” of vaccinating children on the basis of religious or personal beliefs. In other parts of the world,  continued measles outbreaks in Europe, sub-Saharan Africa and Southern Asia have also occurred due to weak routine immunization systems and delayed implementation of accelerated disease control.

Creating and Sustaining an Essential Partnership for Food Safety

Juergen Voegele's picture
Photo by John Hogg / World BankThis week, the Global Food Safety Partnership will hold its third annual meeting in Cape Town, just ahead of the holiday season when food safety issues are not on everyone’s minds. They should be. Unsafe food exacts a heavy toll on people and whole economies, and is cited as a leading cause of more than 200 illnesses. However, safe food does not need to be a luxury—which is something that motivates and animates our work at the World Bank Group. Food availability alone does not guarantee food safety. Increasingly, we are learning how food safety affects people, and disproportionately impacts the lives and livelihoods of poor people.This growing awareness about food safety is partly because of the food scares that have shaken many countries in recent years. Food safety incidents occur anywhere in the world—both in industrialized and developing countries alike and in countries large and small...

Food Safety in Zambia: How Small Improvements Can Have Big Impact

Artavazd Hakobyan's picture

Food Safety is becoming a priority in Zambia. The government is revising its food safety strategy and preparing new legislation to improve and modernize food safety governance.  In the private sector, a number of food enterprises are upgrading their food safety practices to stay on par with their peers abroad and cater to increasingly demanding consumers.

These improvements are timely and appropriate. While the extent of foodborne risks in Zambia isn’t fully known, recurrent cholera and typhoid outbreaks as well as the fact that 60 percent of the population suffers from diarrhea suggest that foodborne pathogens, poor hygiene and sanitation and other food safety risks are having a negative impact. Anecdotal information supports this point. In conversations with partners in Zambia, over a cup of coffee or dinner, I asked what they thought could cause diarrhea? Most of them responded that it was probably something they ate. They complained that while diarrhea was not a “big deal,” and that “their stomachs were used to bacteria,” it reduced productivity because they had to take sick days away from work. Aside from causing a high death rate among children and the elderly, these diseases place a significant burden on straining public health services, reduce the productivity of the working population and constrain development. Furthermore, the economic and human costs of these diseases are huge.

The Importance of Detecting TB Early

Miriam Schneidman's picture

As we enter the second year of the “Stop TB in my lifetime” campaign, it is time to take stock of where we are and look at the key priorities for attaining this worthy goal.  Beyond the banners urging the world to stop this curable disease are the faces of those afflicted by tuberculosis or whose lives were cut prematurely short. These faces remain etched in my memory and reinvigorate my drive to stop TB.


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