Global Healthcare Highlights
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In particular, China, Rwanda and Vietnam built health protection systems in the 21st century, almost from scratch, achieving near universal coverage in only a decade.
These examples show that healthcare protection can be expanded very quickly, and not only at low baseline levels of coverage.
In the last two decades total aggregate global expenditure on healthcare has been relatively stable, albeit with a slow steady increase.
The following visualization uses data from the World Health Organisation published in the World Development Indicators to show this.
Total healthcare spending as a percent of GDP has seen an overall increase of roughly 1. Global trends in healthcare expenditure mask a great deal of heterogeneity.
The following map shows how total expenditure on healthcare has changed across the world. Although trends are not very pronounced for most countries, there are clear exceptions e.
And there are strong differences in levels. World-wide cross-country data also shows that, while the public share of resources used to finance healthcare has been stable in the aggregate, there is substantial underlying heterogeneity in this respect.
This visualization presents the same variable public spending on healthcare as a share of total healthcare but aggregating countries by income levels World Bank classification — this shows that there have been substantial underlying shifts across regions.
More specifically, in countries in the low-income and upper-middle-income brackets, there has been a marked increase in the share of public resources used to finance healthcare; in high-income countries there is no clear trend.
This refers to direct outlays made by households, including gratuities and in-kind payments, to healthcare providers.
The following visualization presents out-of-pocket expenditure on healthcare by country as percent of total healthcare expenditure.
As it can be seen, in high-income countries these outlays tend to account for only a small fraction of expenditure on healthcare e.
Afghanistan, where the share of out-of-pocket expenditure reached Many countries have followed a clear path in the direction of reducing this type of expenditures particularly in the developing world , yet some countries have moved in the opposite direction Russia is a notable case in point, with a threefold increase in the share of out-of-pocket expenditure in the last decade.
Public policy has the scope for affecting health outcomes. We provide here some concrete examples.
Further in-depth information can be found in our entries dedicated to Vaccination , Eradication of Disease , and Healthcare Finances.
This was, to a great extent, motivated by the fact that the share of uninsured individuals in the US is large and has remained virtually constant during decades of substantial growth in expenditure.
The following visualization shows the percentage of individuals in the US without health insurance for the period As we can see there are two marked changes in the trends separated by a long period of remarkable stability: there is a sharp drop in the number of uninsured in with the creation of Medicare and Medicaid, then relatively little change for decades, and then another sharp drop in with the introduction of the ACA.
Disaggregated data shows that those states that decided to expand their Medicaid programs saw larger reductions in their uninsured rates from to , especially when those states had large uninsured populations to start with see Obama While strictly speaking this is only descriptive evidence — we cannot know what would have happened to the trends without the introduction of the ACA —, it seems reasonable to assume that the observed improvements in healthcare coverage are indeed a consequence of the ACA.
The rotavirus is the most common cause of diarrhea and causes , childhood deaths annually estimates. Many more become sick and are hospitalized.
Mexico introduced the rotavirus vaccination between and , and the following graph shows how quick and successful the countrywide vaccination was.
The graph shows the seasonal pattern of the disease and how the lifesaving effect of the vaccine affected different age groups.
Data comparing the prevalence of diseases before and after the introduction of different vaccinations in the US can be found in Roush and Murphy Here we provide a table summarizing their findings.
Today smallpox is a disease of the past. The following map shows when smallpox was eradicated from each country.
But smallpox was eradicated from other parts of the world, especially Europe, far earlier. Essential health services cover a range of basic health provisions, such as detection and treatment of tuberculosis TB , HIV treatment, family planning, sanitation and DTP3 immunization.
The following chart from the WHO shows global coverage trends across the key tracer indicators of essential health services from In general, we see an overall increase in global coverage since However, some health services see a much steeper rise—these are often strongly linked to particular funding and resource efforts stemming from large public policies and coordinated civil-society interventions.
Immunization DTP3 coverage has also seen a considerable increase since This rise has been even more significant across particular regions.
In Africa, for example, DTP3 coverage has increased by almost 50 percent since —again, this is a strong reflection of increased funding in these areas from the global vaccine alliance GAVI , the United Nations agency and additional donor funds.
Increases in coverage of maternal and child health services have typically been slower than that of HIV, TB, malaria and DTP3, but have still shown a steady increase since Like DTP3, this level of increase varies substantially by region; the World Bank reports that antenatal care coverage has increased by 30—60 percent in regions outside of Europe and the Americas.
There are several factors necessary in ensuring everyone has access to essential medicines—first, they must be available, and secondly they must be affordable.
In the chart we see levels of medicine availability from within the public sector blue line , and private sector yellow line across thirty developing countries.
These are shown as the mean availability by region, with minimum and maximum values also shown. There are several important trends to highlight.
Firstly, medicine availability within the public sector in developing countries is low—only 35 percent on average across the 27 countries reported here.
Availability within the private sector is consistently higher, however, this is also not guaranteed—on average, more than one-third of private providers had adequate access to essential medicines.
This has important implications for access to essential medicines—especially for the poorest. Most health facilities in the public sector offer medicines at low-cost or free of charge, so are essential in healthcare provision for the poor.
When medicines are not available in the public sector, individuals must try to access them privately; these are typically more expensive and unaffordable for many.
As we discuss in our entry on Financing Healthcare, price-sensitivity is so critical in low-income countries, that small costs for important healthcare products make a vast difference in demand.
The World Development Indicators WDI , published by the World Bank, are the main source of up-to-date cross-country data on life expectancy, child mortality and maternal mortality.
Other more specialised data sources are listed and discussed in our entries on Life Expectancy and Child Mortality.
The main source of data on international healthcare expenditure is the World Health Organisation WHO , more specifically the global health expenditure database.
Coronavirus pandemic : daily updated research and data. Health Outcomes. How has cross-country life expectancy changed in the long-run?
Click to open interactive version. Have all countries in the world experienced increasing life expectancy? Life expectancy of the world population, , and 1.
In the long run the inequality in life expectancy within countries decreased hugely. How has cross-country child mortality changed in the long-run?
Are developing countries catching up with low child mortality rates in developed countries? The five most lethal infectious diseases over time.
Maternal mortality reduced in the long run. How do countries around the world currently compare in terms of maternal mortality? The global distribution of the disease burden.
What explains changes and differences in health outcomes? How strong is the link between healthcare expenditure and life expectancy?
How strong is the link between healthcare expenditure and child mortality? How strong is the link between healthcare expenditure and national income?
When did high-income countries start expanding their healthcare systems? How quickly can healthcare coverage expand?
Evolution of health protection coverage as a percentage of total population, selected countries — Figure 4. Has aggregate global expenditure on healthcare increased in the last couple of decades?
How has healthcare expenditure evolved across different countries? Leigh Manning 17 03, 43 min read.
Amber Donovan-Stevens 12 03, 17 min read. Shaun Bowie 15 06, 23 min read. William Smith 15 06, 4 min read. William Smith 08 06, 4 min read.
William Smith 05 06, 5 min read. Richard Hibbert 13 06, 10 min read. Frederic Gomer 12 06, 5 min read.
Jason Chester 07 06, 10 min read. William Girling 24 06, 7 min read. In addition, I value the enormous contribution our nurses make for the wellbeing of all.
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We value most our people, that is, our employee-agency-employer relationships.JPMORGAN FUNDS-GLOBAL HEALTHCARE FUND - A USD ACC (A0RPE0 | LU): Aktuelle Informationen zum Fonds, Charts und Performance. iShares Global Healthcare ETF. NAV per Jun USD 52W-Bandbreite - ; NAV per Jun (%); NAV Total Return as of So investiert der JPMorgan Funds - Global Healthcare Fund A (acc) - EUR Fonds: Der Teilfonds strebt die Erzielung einer Rendite durch die vorwiegende. Global Health Care Outlook Die Evolution von „Smart Health Care“. Das Gesundheitswesen des Jahrhunderts wird wesentlich von Qualität. Globales Research schafft Informationsvorteile. Für den Global Healthcare Fund sucht das Fondsmanagement um Anne Marden nach Unternehmen mit. Retrieved 3 March There are several factors necessary in ensuring everyone has access to Halloween Spiele medicines—first, they must be available, and secondly they must be affordable. Charity assessment Demandingness objection Disability-adjusted life year Earning to give Equal consideration of interests Marginal utility Quality-adjusted life year Utilitarianism Venture philanthropy. This pattern is similar to that observed between life expectancy and per capita income. In this entry we provide an overview of the available empirical evidence on aggregate health outcomesfocusing on long-run cross-country data from mortality and morbidity tables; and then here an analysis of available evidence on health determinantsfocusing specifically on the returns to macro healthcare investments. Categories : Global health.
Since women gave birth much more often than today , the death of the mother was a common tragedy. Today, these countries have maternal mortality rates close to 10 per , live births.
The decline of maternal mortality to around 10 per , births can be attributed to our modern scientific understanding of the causes leading to maternal mortality.
It was the physician Ignaz Semmelweis who first noticed the link between hygiene and the survival of mothers in the middle of the 19th century, but it was only until the germ theory of disease became known that appropriate practices became widely adopted.
The same chart also shows that different countries have achieved progress in maternal mortality at different points in time. Malaysia in contrast achieved this progress in only a few decades.
Recent data on maternal mortality shows improvements around the world. The following interactive visualization presents a world map of maternal mortality rates for the period You can switch to the chart view to explore country-specific trends.
As before, the conclusion here is that despite recent widespread improvements in the developing world, there are huge challenges ahead: in sub-Saharan Africa more than mothers die per , live births.
This is more than 60 times higher than the figure for countries in the European Union. In the preceding sections we discussed health outcomes, as measured only from data on mortality.
This does not take the morbidity from disease and disability into account. The burden of disease is a related, but different measure of health outcomes that accounts for both the mortality and the morbidity of disease.
This variable is calculated as the sum of years of potential life lost due to premature mortality, and the years of healthy life lost due to disease and disability.
You can read more about the definition and calculation of DALYs in the technical report WHO methods and data sources for global burden of disease estimates.
Further in-depth information on burden of disease can be found in our dedicated entry on Burden of Disease.
This map shows DALYs per , people of the population. It is thereby measuring the distribution of the burden of both mortality and morbidity around the world.
We see that rates across the regions with the best health are below 20, DALYs per , individuals. Here we discuss trends showing how the fight against these diseases is evolving.
The most common way of measuring the evolution of diseases is to estimate the number and frequency of deaths caused by the diseases; as well as the number of new people suffering from them.
Between and more than 3 million people were infected with HIV ever year. Since then the number of new infections began to decline and in it was reduced to below 2 million.
The lowest number of new infections since The number of AIDS-related deaths increased throughout the s and reached a peak in , when in both years close to 2 million people died.
Since then the annual number of deaths from AIDS declined as well and was since halved. The chart also shows the continuing increase in the number of people living with HIV.
The rate of increase has slowed down compared to the s, but the absolute number is at the highest ever with more than 36 million people globally living with HIV.
As such, health is often thought of as an individual characteristic beginning with inherited conditions e. More information about the provision of healthcare can be found in our entry on Financing Healthcare.
One of the most important inputs to health is health care. Here we study cross-country evidence of the link between aggregate healthcare consumption and production, and health outcomes.
One common way of measuring national healthcare consumption and production is to estimate aggregate expenditure on healthcare typically expressed as a share of national income.
This visualization shows the cross-country relationship between life expectancy at birth and healthcare expenditure per capita.
The chart shows the level of both measures at two points in time, about a generation apart and respectively. The arrows connect these two observations, thereby showing the change over time of both measures for all countries in the world.
As it can be seen, countries with higher expenditure on healthcare per person tend to have a higher life expectancy. And looking at the change over time, we see that as countries spend more on health, life expectancy of the population increases.
This means the proportional highest gains are achieved in poor countries with low baseline levels of spending.
This pattern is similar to that observed between life expectancy and per capita income. The countries are color-coded by world region, as per the inserted legends.
Many of the green countries Sub-Saharan Africa achieved remarkable progress over the last 2 decades: health spending often increased substantially and life expectancy in many African countries increased by more than 10 years.
The most extreme case is Rwanda, where life expectancy has increased from 32 to 64 years since — which was one year after the Rwandan genocide.
The two most populous countries of the world — India and China — are emphasized by larger arrows. It is interesting to see that in China achieved already relatively good health outcomes at comparatively low levels of health spending.
The association between health spending and increasing life expectancy also holds for rich countries in Europe, Asia, and North America in the upper right corner of the chart.
The US is an outlier that achieves only a comparatively short life expectancy considering the fact that the country has by far the highest health expenditure of any country in the world.
The following visualization presents the relationship between child mortality and healthcare expenditure per capita. Global data on health expenditure per capita is available since and in this chart we show the level of both measures in the first and last year for which data is available.
The arrows connect these two observations, thereby showing the change over time for all countries in the world. We can see that child mortality is declining as more money is spent on health.
Focusing on changes over time, we can see a particularly striking fact: while there is huge inequality in levels — child mortality in the best-performing countries is almost times lower than in the worst — inequality in trends is surprisingly stable.
Specifically, if you look at the paths over time it is surprising how little heterogeneity there is between very different countries in the world.
No matter whether it is a rich country in Europe or a much poorer country in Africa, the proportional decline in child mortality associated with a proportional increase in health expenditure is remarkably similar.
The visualization also shows the very high global inequality in health spending per capita that is still prevalent today.
The ratio between the two countries is ; on average Americans spent more on health per day than a person in the Central African Republic spends in an entire year.
You can also explore this relationship between healthcare spending and child mortality in this interactive visualization. At a cross-country level, the strongest predictor of healthcare spending is national income you can find more about measures of national income in our entry on GDP data.
The following visualization presents evidence of this relationship. The correlation is striking: countries with a higher per capita income are much more likely to spend a larger share of their income on healthcare.
In a seminal paper, Newhouse 4 showed that aggregate income explains almost all of the variance in the level of healthcare expenditure specifically, Newhouse showed that among a group of 13 developed countries, GDP per capita explained 92 percent of the variance in per capita health expenditure.
Other studies have confirmed that this strong positive relationship remains after accounting for additional factors, such as country-specific demographic characteristics.
In the preceding section we provide evidence supporting the fact that there are potentially large health returns to healthcare investments.
Here we explore empirical evidence regarding how healthcare investments are financed around the world. In depth information on healthcare expenditure and finances, including definitions and data sources, can be found in our entry on Financing Healthcare.
The earliest data on financing of healthcare dates back to the late 19th century — this is when many European countries began officially establishing healthcare systems through legislative acts.
The following visualization presents public expenditure on healthcare as a percent of GDP for a selection of high-income countries for the period using data from Tanzi and Schuknecht 7 and Lindert 8.
As it can be appreciated, public expenditure on healthcare in all of these countries followed roughly similar paths; and this is despite early differences in their healthcare regimes for a detailed account of the institutional evolution of healthcare regimes in these countries see the report prepared by CESifo DICE.
As noted above, european countries pioneered the expansion of healthcare systems in the first half of the twentieth century.
The following visualization, from the Human Development Report , places the achievements of these countries in perspective.
Specifically, the following graph plots healthcare protection coverage for a selection of countries during the period As we can see, France, Austria and Germany increased healthcare coverage in the years , while Spain, Portugal and Greece did it later, in the years Interestingly, however, this graph also shows some notable examples of countries that expanded healthcare coverage much later, but much more quickly.
In particular, China, Rwanda and Vietnam built health protection systems in the 21st century, almost from scratch, achieving near universal coverage in only a decade.
These examples show that healthcare protection can be expanded very quickly, and not only at low baseline levels of coverage. In the last two decades total aggregate global expenditure on healthcare has been relatively stable, albeit with a slow steady increase.
The following visualization uses data from the World Health Organisation published in the World Development Indicators to show this.
William Smith 08 06, 4 min read. William Smith 05 06, 5 min read. Richard Hibbert 13 06, 10 min read. Frederic Gomer 12 06, 5 min read.
Jason Chester 07 06, 10 min read. William Girling 24 06, 7 min read. Kayleigh Shooter 16 06, 8 min read.
William Smith 10 06, 4 min read. Karina Malhotra 04 07, 11 min read. William Smith 03 07, 4 min read.
Numerous international funds have been set up in recent times to address global health challenges such as HIV.
Globally, An estimated 0. The WHO African region remains most severely affected, with nearly 1 in every 25 adults 4. Globally, HIV is primarily spread through sexual intercourse.
The risk-per-exposure with vaginal sex in low-income countries from female to male is 0. Malaria is a mosquito-borne infectious disease caused by the parasites of the genus Plasmodium.
Symptoms may include fever, headaches, chills, and nausea. Each year, there are approximately million cases of malaria worldwide, most commonly among children and pregnant women in developing countries.
International travellers to endemic zones are advised chemoprophylaxis with antimalarial drugs like Atovaquone-proguanil, doxycycline, or mefloquine .
In , about million children were underweight, and undernutrition contributes to about one third of child deaths around the world.
Infection can further contribute to malnutrition. Violence against women has been defined as: "physical, sexual and psychological violence occurring in the family and in the general community, including battering, sexual abuse of children, dowry-related violence, rape, female genital mutilation and other traditional practices harmful to women, non-spousal violence and violence related to exploitation, sexual harassment and intimidation at work, in educational institutions and elsewhere, trafficking in women, forced prostitution and violence perpetrated or condoned by the state.
Although statistics can be difficult to obtain as many cases go unreported, it is estimated that one in every five women faces some form of violence during her lifetime, in some cases leading to serious injury or even death.
Preventing the violence against women needs to form an essential part of the public health reforms in the form of advocation and evidence gathering.
Primary prevention in the form of raising women economic empowerment facilities, microfinance and skills training social projects related to gender equality should be conducted.
Activities promoting relationship and communication skills among couples, reducing alcohol access and altering societal ideologies should be organized.
Childhood interventions, community and school- based education, raising media-oriented awareness and other approaches should be carried out to challenge social norms and stereotypical thought processes to promote behavioral alterations among men and raise gender equality.
Trained health care providers would play a vital role in secondary and tertiary prevention of abuse, by performing early identification of women suffering from violence and contributing to the addressal of their health and psychological needs.
They could be highly important in prevention of the recurrence of violence and the mitigation of its effects on the health of the abused women and their children.
For example, the rate of type 2 diabetes , associated with obesity , has been on the rise in countries previously plagued by hunger.
In low-income countries, the number of individuals with diabetes is expected to increase from 84 million to million by More than one billion people were treated for at least one neglected tropical disease in They are variously caused by bacteria Trachoma, Leprosy , viruses Dengue,  Rabies , protozoa Human African trypanosomiasis, Chagas , and helminths Schistosomiasis, Onchocerciasis, Soil transmitted helminths.
Surgery remains grossly neglected in global health, famously described by Halfdan T. Mahler as the 'neglected stepchild of global health'.
This particularly affects low-resource settings with weak surgical health systems. There is significant variation in outcomes associated with the development level of the country where surgery is taking place.
A prospective study of 10, adults undergoing emergency abdominal surgery from centres across 58 countries found that mortality is three times higher in low- compared with high-human development index HDI countries even when adjusted for prognostic factors.
The right to health care is a key component of the Universal Declaration of Human Rights and has lacked the appropriate attention in low-income countries in recent history   .
Surgical diseases can result in considerable morbidity and mortality for individuals whom are unable to access appropriate care, yet in low-income countries, this category of disease has been deemed too expensive to invest in .
In recent years, however, it has been recognized that surgical diseases are a neglected health problem of great proportion and requires urgent prioritization .
Global interventions for improved child health and survival include the promotion of breastfeeding, zinc supplementation, vitamin A fortification, salt iodization , hygiene interventions such as hand-washing, vaccinations, and treatments of severe acute malnutrition.
Many populations face an "outcome gap", which refers to the gap between members of a population who have access to medical treatment versus those who do not.
Countries facing outcome gaps lack sustainable infrastructure. In the private sector, highest- and lowest-priced medicines were Treatments were generally unaffordable, costing as much as 15 days wages for a course of the antibiotic ceftriaxone.
Journalist Laurie Garrett argues that the field of global health is not plagued by a lack of funds, but that more funds do not always translate into positive outcomes.
The problem lies in the way these funds are allocated, as they are often disproportionately allocated to alleviating a single disease.
Data from WHO and the World Bank indicate that scaling up infrastructure to enable access to surgical care in regions which it is currently limited or non-existent is, in fact, a low-cost measure relative to the significant morbidity and mortality caused by lack of surgical treatment .
From a cost perspective, studies at district hospitals have demonstrated that provision of basic surgical care can be on par with vaccination programs, which counters a common perception of surgical care as a financially prohibitive endeavor in LMICs .
Bellwether procedures are considered a minimum level of care that first-level hospitals should be able to provide in order to capture the most basic emergency surgical care.
These include 3 main surgical procedures; laparotomy for abdominal emergencies , caesarean section, and treatment of an open fracture   .
This would require anaesthetists, obstetricians, surgeons, nurses, and facilities with operating theatres and pre- and post-surgical care capabilities.
The Global Health Security Agenda GHSA is "a multilateral, multi-sector effort that includes 60 participating countries and numerous private and public international organizations focused on building up worldwide health security capabilities toward meeting such threats" as the spread of infectious disease.
GHSA works through four main mechanisms of member action, action packages, task forces and international cooperation. Action Packages are a commitment by member countries and their partners to work collaboratively towards development and implementation of International Health Regulations IHR.
Each action package consists of five-year targets, measures of progress, desired impacts, country commitments, and list of baseline assessments.
In September , a pilot tool was developed to measure progress of the Action Packages and applied in countries Georgia, Peru, Uganda, Portugal, the United Kingdom, and Ukraine that volunteered to participate in an external assessment.
From Wikipedia, the free encyclopedia. Health of populations in a global context. For the bibliographic database, see Global Health database.
See also: Timeline of global health. No data. Less than 9, Over Main article: Disability-adjusted life year. Main article: Quality-adjusted life year.
Main articles: Infant mortality and Child mortality. Main article: Morbidity. Main articles: Maternal health and Reproductive health.
Main article: Malaria. Main article: Domestic violence. Main article: Non-communicable disease. Main article: Neglected tropical diseases.
See also: Health human resources.