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Russian Federation

«Оттепель», или Россия против курения

Patricio V. Marquez's picture

Возможно, эта информация осталась для вас не замеченной, но этой зимой Россия совершила важнейший прорыв к улучшению состояния здоровья населения страны, заслуживающий самой высокой оценки: в стране принят федеральный закон, запрещающий курение в общественных местах и ограничивающий продажу сигарет. Таким образом, Россия присоединилась к многочисленным странам, в которых борьба с курением отнесена к первоочередным задачам здравоохранения.

Back from the Cold: Russia Confronts Tobacco

Patricio V. Marquez's picture

image Wikimedia Commons

You might have missed it over the winter, but Russia achieved an important public health milestone that deserves applause: It enacted a national law that bans smoking in public places and restricts cigarette sales, joining a growing number of countries in making tobacco control a health priority.

The policy victory was a long time coming.

Health information systems in developing countries: Star Wars or reality?

Patricio V. Marquez's picture

(Doctor at the GP office working with prescriptions. Kirov, Russia. Credit: Dmitry Kirillov/World Bank)

In the late 1990s, an international consultant told me that a proposed electronic health information system in the Dominican Republic was “like Star Wars and will not work in this country.”

 

Our objective was to improve service delivery by virtually connecting health providers to share medical records with one another as patients moved from health centers to hospitals. We learned that this was much more than an overnight task, requiring a sustained medium-term effort by the government to get the system fully up and running.

 

In recent years, I’ve seen similar efforts realized in the Russian Federation, Georgia, Azerbaijan and Botswana. In two Russian regions, Chuvash Republic and Voronezh Oblast, for example, electronic records are helping coordinate the flow of clinical and financial information across the health systems as facilities, departments within hospitals, and health insurance agencies have been “virtually” connected through broadband networks. The electronic records are supporting clinical decision-making, facilitating performance measurement and pay-for-performance initiatives, and ultimately the continuity of care as patients move across the health system. Inter- and intra-regional medical consultations and distance learning activities are also being supported by telemedicine networks that connect specialized hospitals with general facilities.

Are all medical procedures, drugs good for the patient?

Patricio V. Marquez's picture

Also available in: РусскийPatients waiting at health center in Angola (credit: UN/Evan Schneider).

When healthcare professionals take the Hippocratic Oath, they promise to prescribe patients regimens based on their “ability and judgment” and to “never do harm to anyone”.

Although extraordinary progress in medical knowledge during the last 50 years, coupled with the development of new technologies, drugs and procedures, has improved health conditions and quality of life, it has also created an ever-growing quandary regarding which drugs, medical procedures, tests and treatments work best.

And for policy makers, administrators and health economists, the unrestrained acquisition and use of new medical technologies and procedures (e.g., open heart surgery to replace clogged arteries, ultrasound technology scanners to aid in the detection of heart disease, and life-saving antiretroviral drugs for HIV/AIDS) is increasing health expenditures in an era of fiscal deficits.

In many countries, I’ve see how ensuring value for money in a limited-resources environment is not only difficult but requires careful selection and funding of procedures and drugs. It also comes with serious political, economic and ethical implications—and with new drugs and technologies appearing every day, this challenge isn’t going away. What should countries do?

Все ли методы лечения и лекарства хороши для пациента?

Patricio V. Marquez's picture

Patients waiting at health center in Angola (credit: UN/Evan Schneider).

Принимая клятву Гиппократа, профессионалы из области здравоохранения обязуются лечить пациентов, основываясь на своих «способностях и суждениях», а так же «никогда и никому не навредить».

Впечатляющий прорыв в области врачебных знаний за последние 50 лет, сопровождаемый развитием новых высоких технологий, лекарств и методик лечения, значительно улучшил средний уровень здоровья и качества жизни в целом. Однако при этом зачастую это приводит к ситуации, когда все труднее и труднее становится определять, какие же лекарственные средства, методики, тесты и процедуры окажутся самыми эффективными.

 

 Для тех, кто принимает решения и управляет экономикой здравоохранения, бесконечное приобретение и внедрение новых медицинских технологий и процедур (например, операции на открытом сердце, ультразвуковая сканеры для выявления болезней сердца, а так же антиретровирусная терапия против ВИЧ/СПИД) ведет к существенному росту расходов на здравоохранение, особенно заметного в эпоху бюджетных дефицитов.

Making a public health case for safer roads

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Also available in: Русский

ARA0171UZB World Bank

On recent visits to Moscow and Tbilisi, and driving from Baku to the Sheki and Agdash regions in Azerbaijan, I observed challenges and progress in making roads safer. Why should this matter to public health folks? Or should this be only the concern of engineers?

If one of the goals of development is to improve health outcomes by reducing premature mortality, injuries and disability, then unsafe roads are a key public health challenge.

In Eastern Europe and Central Asia (ECA) the problem is acute. Road traffic deaths rank among the ten leading causes of death: people are 2-3 times more likely to die from road injuries than people in Western Europe. For every death, many more people have injuries that require medical care.

What is causing this problem? For sure, more people are driving because the number of cars has increased significantly due to rising incomes—the traffic jams in some ECA cities vividly reflect this change. Poor road conditions and spotty enforcement of speeding, drunk driving, and seatbelt and helmet laws are leading culprits. “Distracted driving,” due to the growing use of cell phones and texting, is also resulting in more car crashes.

The clock is ticking: attaining the HIV/TB MDG targets in the former Soviet Union countries

Patricio V. Marquez's picture

Some countries of the former Soviet Union, the so-called CIS countries, are facing difficult challenges to achieve the HIV/tuberculosis-related Millennium Development Goal (MDG 6) by 2015. The continuing growth of new HIV cases, insufficient access to prevention services and treatment for people living with HIV, combined with the severity of region’s tuberculosis (TB) epidemic (particularly multi-drug resistant TB) are major challenges.

On October 10-12, 2011, the Russian government, along with UNAIDS, the Global Fund, and the World Bank, is hosting in Moscow a high-level forum to discuss these challenges and ways to reach MDG 6 in the CIS. (Click here for a video, a presentation, and more from the forum.)

Unless concerted action is taken, sustained political commitment mobilized, new public/private and civil society partnerships established, and a sharp improvement in the effectiveness of HIV and TB programs realized, MDG 6 risks not being achieved. So, what to do?

Обратный отсчет: достижение целей развития тысячелетия в области борьбы с ВИЧ и туберкулезом в странах бывшего СССР

Patricio V. Marquez's picture

Некоторые бывшие республики Советского Союза, включая страны СНГ, сталкиваются с серьезными трудностями на пути к цели развития тысячелетия в области борьбы с ВИЧ/туберкулезом (ЦРТ-6), которая должна быть достигнута к 2015 году. Основные проблемы – это продолжающийся рост числа новых случаев инфицирования вирусом ВИЧ, недостаточный доступ к профилактическим услугам и лечению для людей, живущих с ВИЧ, а также острота эпидемии туберкулеза в регионе, особенно туберкулеза с множественной лекарственной устойчивостью.