This document summarizes a research article that tested the hypothesis that HIV prevalence is not associated with governance. The researcher used governance data from the World Bank across six dimensions for 149 countries with UNAIDS HIV prevalence estimates from 2002. When countries were divided into three groups based on mean governance scores, the median HIV prevalence was lower (0.2%) for countries with higher mean governance compared to 0.7% and 0.75% for countries with lower and middle mean governance scores, despite improvements in other health and economic indicators. The results rejected the hypothesis and showed HIV prevalence is significantly associated with poor governance.
From Politics to Parity: Using a Health Disparitiies Index to Guide Legislati...Jim Bloyd, DrPH, MPH
This document discusses the creation of a health disparities index (HDI) to quantify racial health disparities in states over time. The researchers analyzed mortality rates for various diseases in Black and White populations in states from 1999-2005. They calculated disparity values and compiled HDI scores for states. States with the lowest average HDI scores, indicating fewer health disparities, were Massachusetts, Oklahoma, and Washington. The HDI scores correlated with social determinants of health like income inequality and rates of uninsured individuals. The researchers aim to use the HDI to guide legislative efforts to reduce health disparities.
Corruption in Ukraine: Comparative Analysis of National Surveys: 2007, 2009, ...DonbassFullAccess
This report was prepared by the Kiev International Institute of
Sociology in coordination with Lake Research Partners and Karakoyun Strategies in the framework of the USAID funded project «The Ukraine National Initiatives to Enhance
Reforms (UNITER)» implemented by PACT, Inc. Ukraine. Presented in the report are comparative results of National sociological surveys on the state of corruption in Ukraine
conducted in 2007, 2009, 2011, and 2015. The survey was targeted at measuring public perception of the problem of corruption and its experience with it. This report is intended to reach a wide readership.
The algerian economy governed by black corruption an empirical study from 200...sissanim
Abstract
The main objective of this paper is to highlight the concept of corruption and analyses our cumulative knowledge about corruption’s effects on the economic growth in Algeria during the period 2002–2015. This article emphasizes the major source of corruption and how the quality of institutions and government policies could mitigate the risk of corruption or increase it. The findings also show the great role of free media in most developing countries which created a new tendency to talk about the effects of corruption especially in recent years. Using a multiple regression model, we find that a 1% decrease in the corruption index CPI level increases the GDP growth rate by approximately 2,005%. The analysis also revealed that there is a negative relationship between the country rank and the economic growth. Finally, the results suggest that more economic freedom, social and political stability lead to less corruption.
This document discusses corruption in Bangladesh across three paragraphs. It begins by providing background on patterns of corruption and the need to consider both internal and external factors. It then analyzes newspaper reports that show police and local government as the most reported sectors for corruption from 1997-2000. Various tables are presented analyzing the affected classes and types of losses from corruption. It concludes by recommending a comprehensive anti-corruption strategy focused on increasing accountability of the executive and reforming civil service recruitment.
This document discusses socioeconomic issues in medicine. It summarizes that:
1) While only 10% of premature deaths are due to inadequate medical care, 40% are due to unhealthy behaviors like smoking, excessive drinking, obesity, and imprudent sexual behaviors.
2) Lower socioeconomic status is associated with poorer health and higher mortality, due to factors like higher rates of unhealthy behaviors, stress, and lack of control over life circumstances among those of lower socioeconomic status.
3) The United States spends much more on health care than other countries, at over 17% of GDP currently, due to both supply factors, like expensive technologies and specialist care, and demand factors, like consumer appetite for new medical advances
Despite the fact that the global poverty rate has been halved since 2000, intensified efforts are required to boost the incomes, alleviate the suffering and build the resilience of those individuals still living in extreme poverty, in particular in sub-Saharan Africa. Social protection systems need to be expanded and risks need to be mitigated for disaster-prone countries, which also tend to be the most impoverished. (Progress towards the Sustainable Development Goals, 2017)
The purpose of this short paper is to raise an argument that corruption plays a major role in preventing the world from achieving Sustainable Development Goals (SDG), in this paper I particularly focus on corruption on poverty. This is also the same with the former Millennium Development Goals (MDG) that were never met.
Corruption is an issue that is affecting many countries in the world, and there are several approaches that have been found to effective depending on the other external factors. The Unites States has several anti-corruption approaches that were invested in countries of interest such as Afghanistan; however, these have failed dismally. The US government has spent over $70 million in different sectors that was intended to support anti-corruption initiative through the government, law enforcement, and journalists. However, there were several reports that were released indicated the lack of preparation and the strategic flaws in the approach taken by the United States. Afghanistan still poses a security risk to the United States, and public funding towards reconstruction of the country should take an evidence based approach that considers effective mechanisms applies in similar regimes. This paper evaluate the current framework of the procurement to preventing corruption by the United States and evidence based mechanisms by organizations that havebeen resistant to corruption.
Effect of Corruption on Natural Disaster Vulnerability Md Boby Sabur
This document discusses how corruption and lack of state capacity due to low economic development can increase a country's vulnerability to natural disasters. It provides background on Cyclone Sidr which devastated Bangladesh in 2007 and discusses how factors like corruption, poor governance, and a weak economy can undermine disaster preparedness and response efforts. The conceptual framework outlines how corruption decreases government effectiveness and capacity, hinders economic growth, and ultimately impacts a state's ability to protect its citizens from disasters.
From Politics to Parity: Using a Health Disparitiies Index to Guide Legislati...Jim Bloyd, DrPH, MPH
This document discusses the creation of a health disparities index (HDI) to quantify racial health disparities in states over time. The researchers analyzed mortality rates for various diseases in Black and White populations in states from 1999-2005. They calculated disparity values and compiled HDI scores for states. States with the lowest average HDI scores, indicating fewer health disparities, were Massachusetts, Oklahoma, and Washington. The HDI scores correlated with social determinants of health like income inequality and rates of uninsured individuals. The researchers aim to use the HDI to guide legislative efforts to reduce health disparities.
Corruption in Ukraine: Comparative Analysis of National Surveys: 2007, 2009, ...DonbassFullAccess
This report was prepared by the Kiev International Institute of
Sociology in coordination with Lake Research Partners and Karakoyun Strategies in the framework of the USAID funded project «The Ukraine National Initiatives to Enhance
Reforms (UNITER)» implemented by PACT, Inc. Ukraine. Presented in the report are comparative results of National sociological surveys on the state of corruption in Ukraine
conducted in 2007, 2009, 2011, and 2015. The survey was targeted at measuring public perception of the problem of corruption and its experience with it. This report is intended to reach a wide readership.
The algerian economy governed by black corruption an empirical study from 200...sissanim
Abstract
The main objective of this paper is to highlight the concept of corruption and analyses our cumulative knowledge about corruption’s effects on the economic growth in Algeria during the period 2002–2015. This article emphasizes the major source of corruption and how the quality of institutions and government policies could mitigate the risk of corruption or increase it. The findings also show the great role of free media in most developing countries which created a new tendency to talk about the effects of corruption especially in recent years. Using a multiple regression model, we find that a 1% decrease in the corruption index CPI level increases the GDP growth rate by approximately 2,005%. The analysis also revealed that there is a negative relationship between the country rank and the economic growth. Finally, the results suggest that more economic freedom, social and political stability lead to less corruption.
This document discusses corruption in Bangladesh across three paragraphs. It begins by providing background on patterns of corruption and the need to consider both internal and external factors. It then analyzes newspaper reports that show police and local government as the most reported sectors for corruption from 1997-2000. Various tables are presented analyzing the affected classes and types of losses from corruption. It concludes by recommending a comprehensive anti-corruption strategy focused on increasing accountability of the executive and reforming civil service recruitment.
This document discusses socioeconomic issues in medicine. It summarizes that:
1) While only 10% of premature deaths are due to inadequate medical care, 40% are due to unhealthy behaviors like smoking, excessive drinking, obesity, and imprudent sexual behaviors.
2) Lower socioeconomic status is associated with poorer health and higher mortality, due to factors like higher rates of unhealthy behaviors, stress, and lack of control over life circumstances among those of lower socioeconomic status.
3) The United States spends much more on health care than other countries, at over 17% of GDP currently, due to both supply factors, like expensive technologies and specialist care, and demand factors, like consumer appetite for new medical advances
Despite the fact that the global poverty rate has been halved since 2000, intensified efforts are required to boost the incomes, alleviate the suffering and build the resilience of those individuals still living in extreme poverty, in particular in sub-Saharan Africa. Social protection systems need to be expanded and risks need to be mitigated for disaster-prone countries, which also tend to be the most impoverished. (Progress towards the Sustainable Development Goals, 2017)
The purpose of this short paper is to raise an argument that corruption plays a major role in preventing the world from achieving Sustainable Development Goals (SDG), in this paper I particularly focus on corruption on poverty. This is also the same with the former Millennium Development Goals (MDG) that were never met.
Corruption is an issue that is affecting many countries in the world, and there are several approaches that have been found to effective depending on the other external factors. The Unites States has several anti-corruption approaches that were invested in countries of interest such as Afghanistan; however, these have failed dismally. The US government has spent over $70 million in different sectors that was intended to support anti-corruption initiative through the government, law enforcement, and journalists. However, there were several reports that were released indicated the lack of preparation and the strategic flaws in the approach taken by the United States. Afghanistan still poses a security risk to the United States, and public funding towards reconstruction of the country should take an evidence based approach that considers effective mechanisms applies in similar regimes. This paper evaluate the current framework of the procurement to preventing corruption by the United States and evidence based mechanisms by organizations that havebeen resistant to corruption.
Effect of Corruption on Natural Disaster Vulnerability Md Boby Sabur
This document discusses how corruption and lack of state capacity due to low economic development can increase a country's vulnerability to natural disasters. It provides background on Cyclone Sidr which devastated Bangladesh in 2007 and discusses how factors like corruption, poor governance, and a weak economy can undermine disaster preparedness and response efforts. The conceptual framework outlines how corruption decreases government effectiveness and capacity, hinders economic growth, and ultimately impacts a state's ability to protect its citizens from disasters.
This document compares perceptions of corruption in Ethiopia and Sudan using two different data sets. In Sudan, the data focuses on identifying corruption as the most important problem facing the country. In Ethiopia, the data examines perceptions of corruption among local state agents. The analysis finds that concerns and perceptions of corruption increase with education and age, and are also influenced by local conditions like quality of services or drought. Regression analysis is used to examine factors influencing perceptions of corruption at the regional and individual levels in both countries.
Higher incomes are associated with longer life expectancy in the United States. This study analyzed tax and mortality data from 1999-2014 to examine the relationship between income and life expectancy. The key findings were:
1) The gap in life expectancy between the richest and poorest was 14.6 years for men and 10.1 years for women.
2) Income inequality in life expectancy increased over time, with those in the top 5% of incomes seeing larger gains in life expectancy than those in the bottom 5%.
3) Life expectancy varied substantially across local areas for low-income individuals, differing by up to 4.5 years between areas.
4) Differences in life expectancy across areas were correlated with
Florida faces significant health disparities, with minority populations experiencing higher rates of diseases like HIV/AIDS, cervical cancer, and gonorrhea. Uninsurance contributes to these disparities through lack of access to preventative care and treatment. Expanding Medicaid would provide coverage to around 877,000 Floridians and address the disparities. It would improve health outcomes and reduce costs by increasing access to care, lowering uncompensated costs for hospitals by $1.3 billion annually. While expansion faces political opposition, it has majority public support and would benefit both the population and state economy through increased jobs and revenue of over $8 billion.
This document discusses approaches to controlling health care costs in the United States. It compares free market and socialized healthcare systems. A free market system leaves many uninsured and has high administrative costs, while socialized healthcare extends care to all citizens but may increase taxes and wait times. An analysis shows that US healthcare costs have risen much more sharply than in countries with single-payer systems like Canada, where administrative costs are about half of those in the US. Adopting aspects of more efficient single-payer systems could help control costs and improve health outcomes in the US.
The document summarizes health reforms in Mexico from 1943-2004, with a focus on the 2004 reform that established the Health Social Protection System. It overviews declining mortality rates and increasing life expectancy over time. Key aspects of the 2004 reform included establishing universal health care coverage, separating financing from service provision, defining an essential benefits package, and increasing accountability through performance measurement. The reform reorganized Mexico's health system to improve access, quality, and financial protection for all citizens.
Democracy Index 2021: the China challengeGuy Boulianne
The document summarizes the key findings of the Democracy Index 2021 report. It finds that the COVID-19 pandemic has had a negative impact on democracy around the world for a second year in a row. Less than half (45.7%) of the global population now live in a democracy, a decline from 2020. The average global score in the Democracy Index fell from 5.37 in 2020 to 5.28 in 2021, representing the worst score since the index began in 2006. The report also examines the challenge that China's authoritarian model poses to liberal democracy as China's economy and global influence have grown.
Observations on the needs for, the contents of, and many of the practical effects of the Affordable care Act or Obamacare. Understanding its benefits and shortcomings
Republican politicians overwhelmingly oppose action on climate change and reject the scientific consensus. The top .01% earn on average $23.8 million per year, while the top 1% earn over $352,000. A study found that the stock wealth of the richest 12,000 households has surpassed the housing wealth of 108 million households. Paul Singer will get back $2.28 billion, 369% of his original $617 million investment, from Argentina's debt repayment. Close to half of all super-PAC money comes from just 50 mega-donors and their relatives who are trying to influence elections.
CAMA: The global macroeconomic impacts of COVID-19: Seven scenarios (results)TatianaApostolovich
The research of Warwick McKibbin (Australian National University, The Brookings Institution, Centre of Excellence in Population Ageing Research) and Roshen Fernando (Australian National University, Centre of Excellence in Population Ageing Research (CEPAR))
1) Mainstream economics approaches to understanding HIV transmission and prevalence, like rational choice theory, provide insights but have weaknesses due to unrealistic assumptions about free choice and risk perceptions. They also fail to consider important cultural factors.
2) Religious affiliation, like Islam, may show relationships to HIV rates and should be included in analyses, as demonstrated by a study finding lower prevalence in countries with higher Muslim populations.
3) Data on Burkina Faso and Zimbabwe show Burkina Faso has lower HIV prevalence despite similar demographics, which may relate to it being majority Muslim while Zimbabwe is majority Christian.
Economic development injury mortality suic homic acidDaniel Bando
1) The study examined longitudinal data on injury mortality rates and GDP per capita for OECD countries from 1960-1999 to determine if cross-sectional findings showing an inverted U-shaped relationship held true over time for individual countries.
2) The results showed that for higher-income countries, injury mortality rates increased until 1972 and then declined, while for middle-income countries rates increased until 1977 and then declined.
3) Intentional injury mortality rates, such as suicide and homicide, generally increased until countries reached around $13,000-$14,000 GDP per capita, after which rates leveled off or declined.
Chronic diseases are responsible for over half of all deaths globally and are projected to account for two-thirds of deaths by 2025. Chronic diseases are also a major cause of lost productivity. By 2030, chronic diseases are expected to result in the loss of over 33 million productive life years in major emerging economies like Brazil, China, Russia, and India. Organizations have a strong business rationale to address chronic diseases through workplace wellness programs in order to reduce healthcare costs, minimize lost productivity, protect human capital investments, and enhance sustainability.
Estimating the impact of governance quality on development in sub saharan africaAlexander Decker
This document analyzes the impact of governance quality on development in Southern Africa using data from 11 countries from 2005 to 2012. It finds that political stability and voice and accountability have a statistically significant positive effect on development, with political stability having a more pronounced impact. Approximately 25% of the variation in development is explained by political stability and voice and accountability. The random effects model is selected as the most appropriate estimation technique based on the Breusch-Pagan and Hausman tests.
Accidental Mortality in India: Statistical Models for Forecastinginventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
The next pandemic? Non-communicable diseases in developing countries is an Economist Intelligence Unit report. It examines the growing burden of non-communicable diseases (NCDs) in low- and lower-middle-income countries, the drivers of this change, and possible solutions for how healthcare systems can bridge the resource gap to deliver appropriate NCD care for patients. The findings of this report are based on data analysis, desk research and five in-depth interviews with senior healthcare experts.
Business magazine-style report on World Suicide Rate Analysis.
Andy Kirk's The Three Principles of Good Visualization Design was followed to create the report.
Tools used: RStudio, Tableau and Canva
Graphs plotted:
1) Map Chart is used to show the amount of suicide in each country
2) A horizontal bar graph is used to further compare the differences in suicide
counts in each country
3) A single line graph is used to show the amount of suicides committed each year
during the period 1985-2016
4) Stacked 100% Area graph is used to compare the suicide counts among
different age groups, namely 5-14 years,15-24 years, 25-34 years, 35-54 years,
55-74 years
5) Side by side bar chart is used to compare the number of suicide counts
among different age groups, sex-wise
6) A pie chart is used to see the composition of causes of deaths in the US in the year
2017
7) Bubble Chart is used to check out the methods by which people commit
suicide and to check which one causes the maximum death
8) A line graph is used to compare the Suicide count and happiness index for the years 2006 to 2015
9) The correlation matrix is used to find the correlation between different elements.
10) Side by side line graph is used to compare gender wise suicide
percentage in the US
11) Treemaps are used to see the composition of the number of suicides
among the states of US
12) Side by side area graph is used to see the availability of different drugs in the US
over time
Health & Society CSA-Europ Assistance Barometer 2013_press releaseEurop Assistance Group
The survey summarizes the results of the 7th Health & Society Barometer measuring public opinions on healthcare in 8 European countries and the US. It finds that while views on healthcare systems remain mixed in Europe, opinions in the US and France have significantly worsened. It also reports that cancelling medical treatment for financial reasons remains high in the US and 4 European countries including France. Additionally, younger generations are reluctant to support increasing healthcare spending through taxes.
- African American men account for 70% of new HIV/AIDS cases in Los Angeles County, though they represent only 12-14% of the population. The majority of cases are in men ages 20-49.
- Poverty, lack of health insurance, and high incarceration rates negatively impact access to healthcare for African American men with HIV/AIDS in Los Angeles. However, community organizations provide support and work to increase access.
- HIV/AIDS has disproportionate effects in the African American community in Los Angeles County. Efforts are being made to increase testing, prevention, and treatment through programs tailored for at-risk groups.
Governance and Corruption in Health Sector editing9916459210
This document discusses governance and corruption in India's health sector. It provides an overview of good governance and examines the extent of corruption in health care due to poor governance. Corruption reflects poor governance and reduces resources for health care, lowering quality and increasing costs. An unhealthy population is expensive for the government and economy. India faces significant health challenges like cardiovascular diseases and cancer despite economic growth. Corruption in health care means the difference between life and death as it diverts critical resources away from the health system. The document examines objectives like studying the impact of corruption and governance, and solutions to address problems in health care delivery through better governance and policies.
Harvard global economic burden non communicable diseases 2011paulovseabra
This document provides an overview and analysis of the global economic burden of non-communicable diseases (NCDs). It finds that NCDs already pose a substantial economic burden, expected to grow tremendously over the next two decades to $47 trillion in lost global output. This represents 75% of global GDP in 2010. Cardiovascular diseases and mental health conditions are the leading contributors. While high-income countries currently bear most of the burden, the developing world will see a rising share due to population and economic growth. Business leaders also express significant concern about the economic impacts of NCDs. The findings suggest a pressing need for increased prevention and control efforts to curb this mounting threat.
Harnessing Global Health Diplomacy to Curb Corruption in HealthAmr Makady
This document summarizes a research article that examines how corruption affects access to medicines globally. It discusses how over a third of the world's population still lacks access to essential medicines, despite international agreements declaring health a human right. Corruption undermines health systems by reducing resources and access to care, with the greatest burden falling on the poor. It can have economic, health, and government trust impacts. The pharmaceutical sector is particularly vulnerable to corruption due to its profitability, regulation, and complex supply chains. The authors argue that global health diplomacy should be used to prioritize research on health corruption, facilitate dialogue on the issue, and help negotiate frameworks for good governance in health.
This document compares perceptions of corruption in Ethiopia and Sudan using two different data sets. In Sudan, the data focuses on identifying corruption as the most important problem facing the country. In Ethiopia, the data examines perceptions of corruption among local state agents. The analysis finds that concerns and perceptions of corruption increase with education and age, and are also influenced by local conditions like quality of services or drought. Regression analysis is used to examine factors influencing perceptions of corruption at the regional and individual levels in both countries.
Higher incomes are associated with longer life expectancy in the United States. This study analyzed tax and mortality data from 1999-2014 to examine the relationship between income and life expectancy. The key findings were:
1) The gap in life expectancy between the richest and poorest was 14.6 years for men and 10.1 years for women.
2) Income inequality in life expectancy increased over time, with those in the top 5% of incomes seeing larger gains in life expectancy than those in the bottom 5%.
3) Life expectancy varied substantially across local areas for low-income individuals, differing by up to 4.5 years between areas.
4) Differences in life expectancy across areas were correlated with
Florida faces significant health disparities, with minority populations experiencing higher rates of diseases like HIV/AIDS, cervical cancer, and gonorrhea. Uninsurance contributes to these disparities through lack of access to preventative care and treatment. Expanding Medicaid would provide coverage to around 877,000 Floridians and address the disparities. It would improve health outcomes and reduce costs by increasing access to care, lowering uncompensated costs for hospitals by $1.3 billion annually. While expansion faces political opposition, it has majority public support and would benefit both the population and state economy through increased jobs and revenue of over $8 billion.
This document discusses approaches to controlling health care costs in the United States. It compares free market and socialized healthcare systems. A free market system leaves many uninsured and has high administrative costs, while socialized healthcare extends care to all citizens but may increase taxes and wait times. An analysis shows that US healthcare costs have risen much more sharply than in countries with single-payer systems like Canada, where administrative costs are about half of those in the US. Adopting aspects of more efficient single-payer systems could help control costs and improve health outcomes in the US.
The document summarizes health reforms in Mexico from 1943-2004, with a focus on the 2004 reform that established the Health Social Protection System. It overviews declining mortality rates and increasing life expectancy over time. Key aspects of the 2004 reform included establishing universal health care coverage, separating financing from service provision, defining an essential benefits package, and increasing accountability through performance measurement. The reform reorganized Mexico's health system to improve access, quality, and financial protection for all citizens.
Democracy Index 2021: the China challengeGuy Boulianne
The document summarizes the key findings of the Democracy Index 2021 report. It finds that the COVID-19 pandemic has had a negative impact on democracy around the world for a second year in a row. Less than half (45.7%) of the global population now live in a democracy, a decline from 2020. The average global score in the Democracy Index fell from 5.37 in 2020 to 5.28 in 2021, representing the worst score since the index began in 2006. The report also examines the challenge that China's authoritarian model poses to liberal democracy as China's economy and global influence have grown.
Observations on the needs for, the contents of, and many of the practical effects of the Affordable care Act or Obamacare. Understanding its benefits and shortcomings
Republican politicians overwhelmingly oppose action on climate change and reject the scientific consensus. The top .01% earn on average $23.8 million per year, while the top 1% earn over $352,000. A study found that the stock wealth of the richest 12,000 households has surpassed the housing wealth of 108 million households. Paul Singer will get back $2.28 billion, 369% of his original $617 million investment, from Argentina's debt repayment. Close to half of all super-PAC money comes from just 50 mega-donors and their relatives who are trying to influence elections.
CAMA: The global macroeconomic impacts of COVID-19: Seven scenarios (results)TatianaApostolovich
The research of Warwick McKibbin (Australian National University, The Brookings Institution, Centre of Excellence in Population Ageing Research) and Roshen Fernando (Australian National University, Centre of Excellence in Population Ageing Research (CEPAR))
1) Mainstream economics approaches to understanding HIV transmission and prevalence, like rational choice theory, provide insights but have weaknesses due to unrealistic assumptions about free choice and risk perceptions. They also fail to consider important cultural factors.
2) Religious affiliation, like Islam, may show relationships to HIV rates and should be included in analyses, as demonstrated by a study finding lower prevalence in countries with higher Muslim populations.
3) Data on Burkina Faso and Zimbabwe show Burkina Faso has lower HIV prevalence despite similar demographics, which may relate to it being majority Muslim while Zimbabwe is majority Christian.
Economic development injury mortality suic homic acidDaniel Bando
1) The study examined longitudinal data on injury mortality rates and GDP per capita for OECD countries from 1960-1999 to determine if cross-sectional findings showing an inverted U-shaped relationship held true over time for individual countries.
2) The results showed that for higher-income countries, injury mortality rates increased until 1972 and then declined, while for middle-income countries rates increased until 1977 and then declined.
3) Intentional injury mortality rates, such as suicide and homicide, generally increased until countries reached around $13,000-$14,000 GDP per capita, after which rates leveled off or declined.
Chronic diseases are responsible for over half of all deaths globally and are projected to account for two-thirds of deaths by 2025. Chronic diseases are also a major cause of lost productivity. By 2030, chronic diseases are expected to result in the loss of over 33 million productive life years in major emerging economies like Brazil, China, Russia, and India. Organizations have a strong business rationale to address chronic diseases through workplace wellness programs in order to reduce healthcare costs, minimize lost productivity, protect human capital investments, and enhance sustainability.
Estimating the impact of governance quality on development in sub saharan africaAlexander Decker
This document analyzes the impact of governance quality on development in Southern Africa using data from 11 countries from 2005 to 2012. It finds that political stability and voice and accountability have a statistically significant positive effect on development, with political stability having a more pronounced impact. Approximately 25% of the variation in development is explained by political stability and voice and accountability. The random effects model is selected as the most appropriate estimation technique based on the Breusch-Pagan and Hausman tests.
Accidental Mortality in India: Statistical Models for Forecastinginventionjournals
International Journal of Humanities and Social Science Invention (IJHSSI) is an international journal intended for professionals and researchers in all fields of Humanities and Social Science. IJHSSI publishes research articles and reviews within the whole field Humanities and Social Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
The next pandemic? Non-communicable diseases in developing countries is an Economist Intelligence Unit report. It examines the growing burden of non-communicable diseases (NCDs) in low- and lower-middle-income countries, the drivers of this change, and possible solutions for how healthcare systems can bridge the resource gap to deliver appropriate NCD care for patients. The findings of this report are based on data analysis, desk research and five in-depth interviews with senior healthcare experts.
Business magazine-style report on World Suicide Rate Analysis.
Andy Kirk's The Three Principles of Good Visualization Design was followed to create the report.
Tools used: RStudio, Tableau and Canva
Graphs plotted:
1) Map Chart is used to show the amount of suicide in each country
2) A horizontal bar graph is used to further compare the differences in suicide
counts in each country
3) A single line graph is used to show the amount of suicides committed each year
during the period 1985-2016
4) Stacked 100% Area graph is used to compare the suicide counts among
different age groups, namely 5-14 years,15-24 years, 25-34 years, 35-54 years,
55-74 years
5) Side by side bar chart is used to compare the number of suicide counts
among different age groups, sex-wise
6) A pie chart is used to see the composition of causes of deaths in the US in the year
2017
7) Bubble Chart is used to check out the methods by which people commit
suicide and to check which one causes the maximum death
8) A line graph is used to compare the Suicide count and happiness index for the years 2006 to 2015
9) The correlation matrix is used to find the correlation between different elements.
10) Side by side line graph is used to compare gender wise suicide
percentage in the US
11) Treemaps are used to see the composition of the number of suicides
among the states of US
12) Side by side area graph is used to see the availability of different drugs in the US
over time
Health & Society CSA-Europ Assistance Barometer 2013_press releaseEurop Assistance Group
The survey summarizes the results of the 7th Health & Society Barometer measuring public opinions on healthcare in 8 European countries and the US. It finds that while views on healthcare systems remain mixed in Europe, opinions in the US and France have significantly worsened. It also reports that cancelling medical treatment for financial reasons remains high in the US and 4 European countries including France. Additionally, younger generations are reluctant to support increasing healthcare spending through taxes.
- African American men account for 70% of new HIV/AIDS cases in Los Angeles County, though they represent only 12-14% of the population. The majority of cases are in men ages 20-49.
- Poverty, lack of health insurance, and high incarceration rates negatively impact access to healthcare for African American men with HIV/AIDS in Los Angeles. However, community organizations provide support and work to increase access.
- HIV/AIDS has disproportionate effects in the African American community in Los Angeles County. Efforts are being made to increase testing, prevention, and treatment through programs tailored for at-risk groups.
Governance and Corruption in Health Sector editing9916459210
This document discusses governance and corruption in India's health sector. It provides an overview of good governance and examines the extent of corruption in health care due to poor governance. Corruption reflects poor governance and reduces resources for health care, lowering quality and increasing costs. An unhealthy population is expensive for the government and economy. India faces significant health challenges like cardiovascular diseases and cancer despite economic growth. Corruption in health care means the difference between life and death as it diverts critical resources away from the health system. The document examines objectives like studying the impact of corruption and governance, and solutions to address problems in health care delivery through better governance and policies.
Harvard global economic burden non communicable diseases 2011paulovseabra
This document provides an overview and analysis of the global economic burden of non-communicable diseases (NCDs). It finds that NCDs already pose a substantial economic burden, expected to grow tremendously over the next two decades to $47 trillion in lost global output. This represents 75% of global GDP in 2010. Cardiovascular diseases and mental health conditions are the leading contributors. While high-income countries currently bear most of the burden, the developing world will see a rising share due to population and economic growth. Business leaders also express significant concern about the economic impacts of NCDs. The findings suggest a pressing need for increased prevention and control efforts to curb this mounting threat.
Harnessing Global Health Diplomacy to Curb Corruption in HealthAmr Makady
This document summarizes a research article that examines how corruption affects access to medicines globally. It discusses how over a third of the world's population still lacks access to essential medicines, despite international agreements declaring health a human right. Corruption undermines health systems by reducing resources and access to care, with the greatest burden falling on the poor. It can have economic, health, and government trust impacts. The pharmaceutical sector is particularly vulnerable to corruption due to its profitability, regulation, and complex supply chains. The authors argue that global health diplomacy should be used to prioritize research on health corruption, facilitate dialogue on the issue, and help negotiate frameworks for good governance in health.
Research done while in PwC Mexico. A short version was included as part of a PwC publication "Future of Pacific Alliance", that was presented at the presidental summit in Chile on July 2016.
Role of Public Health in Health and social Care
Table of Contents
INTRODUCTION.. 4
TASK-1. 5
1.1 Role of different agencies in identifying levels in health and disease in communities. 5
1.2 Statistics on the incidence and spread of infectious disease. Explain the epidemiology of one infectious and non-infectious disease and relevance of statistics in context to public health. 7
1.3 Evaluate the effectiveness of different approaches and strategies to control the incidence of disease in communities. 8
TASK-2 Be able to investigate the implications of illness and disease in communities for the provision of health and social care services. 9
2.1 Determine what are the current approaches to the provision of services for the people with disease or illness. 9
2.2 Explain the relationship between the prevalence of different diseases and the requirements of services to support individuals with the health and social care service
Understanding Linkages between Governance and Health: Concepts and EvidenceHFG Project
There is a lack of evidence and understanding of the dynamics of interventions and contexts in which improved health system governance can contribute to improved health outcomes. As donors and governments increase their emphasis on improving the accountability and transparency of health systems, there is an ever increasing need for this evidence. Governance interventions could then more effectively contribute to measurable improvements in health
outcomes such as reduction in maternal or child mortality, or increased coverage of HIV/AIDS treatment.
On September 14, 2016 the USAID Health Finance and Governance Project (HFG) supported the USAID Office of Health Systems (OHS) and WHO to co-sponsor a workshop to launch a major initiative to marshal the evidence of how health governance contributes to health system performance and ultimately health outcomes. The marshaling of evidence activity will culminate in a high level international event in June 2017 to share knowledge and foster dialogue between donors, researchers, health governance practitioners, and policy makers.
The event brings together important USAID and WHO initiatives to elevate the importance of health governance. The HFG workshop included 35 health and governance professionals from across USAID (OHS, the Center of Excellence for Democracy, Rights and Governance, and the Bureau for Economic Growth, Education and Environment), the WHO, World Bank, academic partners, and implementing partners to launch the marshaling the evidence effort.
This paper analyzes the relationship between women empowerment, as measured by the proportion of seats held by women in national parliament, and corruption. It uses data from multiple countries over 2001-2010 and controls for various economic and socio-political variables. Preliminary OLS regressions found women empowerment benefits developed countries more than developing countries. However, instrumental variable regressions concluded women empowerment is beneficial for reducing corruption in both developing and developed countries. The paper is organized into sections on literature review, data/model specification, and conclusions.
Globalization has increased risks from international threats like pandemics, environmental degradation, and ethnic violence. Strategies are needed to deal with these threats through improved surveillance, distribution of medicines, and understanding the causes of conflicts. Preventive actions before crises occur are important but difficult for governments. Underlying economic issues from globalization like unemployment and inequality can contribute to these threats if not addressed through education, health programs, and infrastructure investment. International cooperation through organizations like WHO and UN is vital to strengthen global efforts against diseases and support national health systems.
The document discusses the importance of addressing gender equality in Global Fund proposals and responses to HIV, TB, and malaria. It notes that women often have less access to health services and information than men due to social and economic inequalities. It provides examples of how diseases like HIV, malaria, and TB disproportionately impact women. The document advises applicants to involve gender experts and conduct a gender analysis to ensure their proposals address the specific needs of women, men, girls and boys. It also recommends integrating gender-sensitive and transformative interventions that promote human rights and reduce health inequalities.
The value of health to an economy is hard to quantify, but its importance is undeniable. A population’s health plays a key role in economic progress, and in coming years healthcare will be a key area of focus for policymakers, payers,providers and the public alike. Financing the future: Choices and challenges in global health studies the role of healthcare against a backdrop of changing demographic patterns, rising healthcare costs and technological innovation.
- The geriatric population living in nursing facilities is at high risk for falls due to multiple intrinsic and extrinsic risk factors.
- Intrinsic risk factors include advanced age, history of falls, gait and balance impairments, muscle weakness, visual impairments, cognitive impairments, and chronic conditions like arthritis and diabetes.
- Extrinsic risk factors include environmental hazards within the nursing facility like uneven surfaces, poor lighting, lack of grab bars in bathrooms, and unsafe footwear.
- Comprehensive fall risk assessments and targeted interventions are needed to address both intrinsic and extrinsic risk
SDH and Basic Measurments in Epid.22 (1).pdfRiyadu
Social determinants of health are factors that influence individual and population health outcomes. These factors include the physical environment, social and economic conditions, and health behaviors. They account for a significant degree of variability in how long and how well people live. Key social determinants include access to healthcare, income/socioeconomic status, education, physical environment, social support systems, employment status, and community safety. Addressing social determinants through multisectoral policies and interventions can help reduce health inequalities within and between countries.
A new health and development paradigm post-2015: grounded in human rightsLisa Hallgarten
Marge Berer, Editor of RHM, presentation at meeting
Divided we stand? Universal health coverage and the unfinished agenda of the health MDGs
Institute of Tropical Medicine, Antwerp February 11th 2014
CHAPter3ConneCting tHe strAtegiC Dots Does Hit mAt.docxtiffanyd4
CHAPter
3
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learning objectives
1. List and define five major challenges facing healthcare delivery systems
today.
2. Describe the complexity of these interrelated challenges for healthcare
and healthcare information technology.
3. Illustrate the history, development, and current state of healthcare
information systems.
4. Name and describe the four categories of healthcare information
systems.
5. Analyze the key priorities of healthcare information systems today that
will affect their future.
Healthcare information technology: the future is now
Healthcare delivery continues to be an information-intensive set of processes.
A series of Institute of Medicine (IOM 1999, 2001) studies suggests that
high-quality patient care relies on careful documentation of each patient’s
medical history, health status, current medical conditions, and treatment
plans. Financial information is essential for strategic planning and efficient
operational support of the patient care process. Management of healthcare
organizations requires reliable, accurate, current, secure, and relevant clini-
cal and administrative information. A strong argument can be made that the
healthcare field is one of the most information-intensive sectors of the US
economy.
Information technology has advanced to a high level of sophistication.
However, technology can only provide tools to aid in the accomplishment
of a wider set of organizational goals. Analysis of information requirements
in the broader organizational context should always take precedence over a
rush to computerize. Information technology by itself is not the answer to
management problems; technology must be part of a broader restructuring
of the organization, including reengineering of business processes. Alignment
1
Glandon-Proof.indb 3 6/10/13 11:40 AM
I n f o r m a t i o n S y s t e m s f o r H e a l t h c a r e M a n a g e m e n t4
of information technology strategy with management goals of the healthcare
organization is essential. Despite these cautions, effective design, implemen-
tation, and management of healthcare information technology (HIT) show
great promise (De Angelo 2000; Glaser and Garets 2005; Kaushal, Barker,
and Bates 2001; Smaltz et al. 2005a).
An essential element in a successful information systems implementa-
tion is carefully planned teamwork by clinicians, managers, and technical
systems specialists. Information systems developed in isolation by technicians
may be technically pure and elegant in design, but rarely will they pass the
test of reality in meeting organizational requirements. On the other hand,
very few managers and clinicians possess the equally important technical
knowledge and skills of systems analysis and design, and the amateur analyst
cannot hope to avoid the havoc that can result from a poorly designed sys-
tem. A balanced effort is required: Operational personnel contribut.
CHAPter3ConneCting tHe strAtegiC Dots Does Hit mAt.docxmccormicknadine86
CHAPter
3
ConneCting tHe strAtegiC Dots:
Does Hit mAtter?
learning objectives
1. List and define five major challenges facing healthcare delivery systems
today.
2. Describe the complexity of these interrelated challenges for healthcare
and healthcare information technology.
3. Illustrate the history, development, and current state of healthcare
information systems.
4. Name and describe the four categories of healthcare information
systems.
5. Analyze the key priorities of healthcare information systems today that
will affect their future.
Healthcare information technology: the future is now
Healthcare delivery continues to be an information-intensive set of processes.
A series of Institute of Medicine (IOM 1999, 2001) studies suggests that
high-quality patient care relies on careful documentation of each patient’s
medical history, health status, current medical conditions, and treatment
plans. Financial information is essential for strategic planning and efficient
operational support of the patient care process. Management of healthcare
organizations requires reliable, accurate, current, secure, and relevant clini-
cal and administrative information. A strong argument can be made that the
healthcare field is one of the most information-intensive sectors of the US
economy.
Information technology has advanced to a high level of sophistication.
However, technology can only provide tools to aid in the accomplishment
of a wider set of organizational goals. Analysis of information requirements
in the broader organizational context should always take precedence over a
rush to computerize. Information technology by itself is not the answer to
management problems; technology must be part of a broader restructuring
of the organization, including reengineering of business processes. Alignment
1
Glandon-Proof.indb 3 6/10/13 11:40 AM
I n f o r m a t i o n S y s t e m s f o r H e a l t h c a r e M a n a g e m e n t4
of information technology strategy with management goals of the healthcare
organization is essential. Despite these cautions, effective design, implemen-
tation, and management of healthcare information technology (HIT) show
great promise (De Angelo 2000; Glaser and Garets 2005; Kaushal, Barker,
and Bates 2001; Smaltz et al. 2005a).
An essential element in a successful information systems implementa-
tion is carefully planned teamwork by clinicians, managers, and technical
systems specialists. Information systems developed in isolation by technicians
may be technically pure and elegant in design, but rarely will they pass the
test of reality in meeting organizational requirements. On the other hand,
very few managers and clinicians possess the equally important technical
knowledge and skills of systems analysis and design, and the amateur analyst
cannot hope to avoid the havoc that can result from a poorly designed sys-
tem. A balanced effort is required: Operational personnel contribut ...
The National HIV Prevention Inventory provides the first, comprehensive inventory of HIV prevention efforts at the state and local levels in the United States. Based on a survey of 65 health departments, including all state and territorial jurisdictions and six U.S. cities, the Inventory is intended to offer a baseline picture of how HIV prevention is delivered across the country in an effort to provide policymakers, public health officials, community organizations, and others with a more in depth understanding of HIV prevention and the role played by health departments in its delivery.
This document discusses challenges to accessing affordable HIV treatment in middle-income countries. It notes that middle-income countries face a "dual burden" of both infectious diseases like HIV and rising non-communicable diseases. Access to affordable medicines is important for universal healthcare but medicines consume a large portion of health spending. The document examines barriers like pricing, patents, intellectual property regimes, and lack of investment that affect access to affordable essential medicines for HIV treatment and other illnesses. It provides context on global commitments to treatment access and reviews the current and future situation for HIV treatment access in middle-income countries.
Predictive analysis WHO's life expectancy dataset using Tableau data visualis...Tarun Swarup
This document discusses a statistical analysis of factors influencing life expectancy using data from the World Health Organization and United Nations. It describes the dataset, variables considered, and objectives of analyzing relationships between life expectancy and factors like immunization rates, mortality rates, economics, and demographics. Four dashboards are proposed to analyze trends in adult mortality rates, compare life expectancy and infant death rates in populated countries, forecast adult mortality and hepatitis rates in Brazil, and compare GDP in developed and developing countries.
A seminar with Walid Ammar, MD, PhD, Director General, Ministry of Public Health of Lebanon; Professor, The Lebanese University; Senior Lecturer, American University of Beirut.
Moderated by Melani Cammett, Professor of Government, Harvard University.
A seminar with Walid Ammar, MD, PhD, Director General, Ministry of Public Health of Lebanon; Professor, The Lebanese University; Senior Lecturer, American University of Beirut.
This document summarizes a paper about state-NGO partnerships for improving social service delivery. It discusses how partnerships are seen as a way to leverage the scale of states and governance capacity of NGOs. The document analyzes three partnership cases in Pakistan involving healthcare, education, and sanitation. It finds that while all three improved services, only one formed an "embedded partnership" with sustainable cooperation. The key factor for this was the attributes of the NGO leadership - those less dependent on donors and more committed to community were most likely to form embedded partnerships through moral authority and long-term commitment. While donor-supported partnerships often transfer technical skills, they are less likely to introduce governance reforms without such ideal leadership.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Slideshare: http://www.slideshare.net/PECBCERTIFICATION
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
2. BMC International Health and Human Rights 2005, 5:4 http://www.biomedcentral.com/1472-698X/5/4
Page 2 of 10
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of gender equality and empowerment of women, reduc-
tion in child mortality and the eradication of extreme pov-
erty and hunger.
Some of the shared societal structures underpinning eco-
nomic growth and health are the absence of violence, gov-
ernment effectiveness, the rule of law, lack of corruption
and the ability to select a government. Even though all of
these are clearly desirable the relative weight of each soci-
etal structure necessary for a strong nation state is debata-
ble [5]. The risk of infectious disease is determined not
only by pathogens and the response of the patient but also
by powerful societal forces that override individual
knowledge and choice [6]. Paul Farmer has coined the
phrase 'structural violence' that reflects the limit of life
choices, particularly of women, by racism, sexism, politi-
cal violence, and grinding poverty.
The 2004 World Health Report discusses the challenges of
tackling the HIV pandemic [7]. In the African continent,
HIV is implicated in poor economic performance and fall-
ing gross domestic product (GDP). Within this document
it describes the wide range of international support gar-
nered to meet this challenge. However, even though the
requirement of local and national government co-opera-
tion is stressed within this document, it does not elaborate
on the massive heterogeneity inherent within this manda-
tory component.
In order to investigate the strength of the relationship
between the quality of societal structures and the HIV pan-
demic, World Bank and UNAIDS sources were used to test
the null hypothesis: "HIV prevalence is not associated
with governance".
Methods
A recent World Bank paper entitled Governance Matters
III collated governance indicators for 199 countries /
regions [8]. Governance in this document has been bro-
ken down into six dimensions that are defined in Table 1.
Using these definitions, this research collected data for
each country from 18 sources that are listed in Table 2.
Governance data were then aggregated for each country
and plotted along a continuum. Only the 2002 Govern-
ance data has been used in this paper. This dataset is avail-
able in a spreadsheet format from the World Bank website
[9].
The 2002 HIV prevalence estimates were obtained for
each country. HIV prevalence is the percentage of adults
aged between 15 and 49 years of age infected with HIV.
One hundred and forty nine of the 199 countries / regions
cited by the World Bank paper had published UNAIDS
2002 HIV prevalence estimates. Those countries / regions
Table 1: Definitions of governance dimensions
Voice and accountability
"how those in authority are selected and replaced"
Political Stability
"perceptions of the likelihood that the government in power will be
destabilized or overthrown by possibly unconstitutional and/or
violent means, including domestic violence and terrorism"
Government Effectiveness
"we combine into a single grouping responses on the quality of public
service provision, the quality of the bureaucracy, the competence of
civil servants, the independence of the civil service from political
pressures, and the credibility of the government's commitment to
policies"
Regulatory Quality
"includes measures of the incidence of market-unfriendly policies such
as price controls or inadequate bank supervision, as well as
perceptions of the burdens imposed by excessive regulation in areas
such as foreign trade and business development"
Rule of Law
"several indicators which measure the extent to which agents have
confidence in and abide by the rules of society. These include
perceptions of the incidence of crime, the effectiveness and
predictability of the judiciary, and the enforceability of contracts"
Corruption
"measures perceptions of corruption, conventionally defined as the
exercise of public power for private gain. Despite this straightforward
focus, the particular aspect of corruption measured by the various
sources differs somewhat, ranging from the frequency of "additional
payments to get things done," to the effects of corruption on the
business environment, to measuring "grand corruption" in the political
arena or in the tendency of elite forms to engage in "state capture" "
Table 2: The sources used for governance data
Afrobarometer
Business Environment Risk Intelligence
Columbia University
The Economist Intelligence Unit
European Bank for Reconstruction and Development
Freedom House
Gallup International
Global Insight's DRI/McGraw-Hill
Heritage Foundation / Wall Street Journal
Institute for Management and Development
Latinobarometro
Political Risk Services
PriceWaterhouseCoopers
Reporters Without Borders
State Department / Amnesty international
World Bank
World Economic Forum
World Markets Research Center
3. BMC International Health and Human Rights 2005, 5:4 http://www.biomedcentral.com/1472-698X/5/4
Page 3 of 10
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excluded from analysis due to the lack of HIV prevalence
data are listed in Table 3. Those countries given a UNAIDS
HIV prevalence estimate of < 0.1% were given a set value
of 0.05%.
In addition to separate analysis of each governance
dimension, an average governance figure was obtained
based on the assumption that each governance dimension
was of equal importance. The null hypothesis was tested
by measuring association between ranked governance and
HIV prevalence data across the whole spectrum of coun-
tries (Kendall tau test, two tailed). Statistical analysis was
performed using SPSS version 12.
Other health and economic data have been included in
the Tables to illustrate the development needs of coun-
tries. The most recent maternal mortality data from the
World Health Organization (WHO) data are available
from the year 2000 [10]. The mean maternal mortality
ratio (MMR) is the number of mothers who die per
100,000 live births. The number of physicians available
per 100,000 inhabitants from 1990–2003 were obtained
from United Nations [11]. Access to improved drinking
water in 2002, expressed as a percentage, was obtained
from WHO / UNICEF [12]. Life expectancy and the GDP
per capita in US dollars corrected for purchaser power par-
ity (GDP-PPP) were obtained from the Central Intelli-
gence Agency World Factbook 2002 [13]. The GINI index
data (1994–2001) from the United Nations are quoted to
give an indication of the equity of income and resource
distribution for each country [14]. A value of zero on the
GINI index indicates fully equitable distribution of
income and resources.
The relative investment by governments in health, educa-
tion and the military is expressed as a ratio. This ratio is
calculated from the percentage of GDP spent on health
and education divided by the percentage of GDP spent on
health, education and the military. Education expenditure
from 2001 and government expenditure on health from
Table 3: Lists those countries that do not have HIV prevalence estimates for 2002
Countries where UNAIDS
commissioned a report but no
HIV prevalence figure was
published
Mean Governance Ranking
position (1 – 199)
Countries / Regions where
UNAIDS did not commission
a report
Mean Governance Ranking
position (1 – 199)
Afganistan 4 Andorra 180
Albania 70 Antigua and Barbuda 146
Brunei 139 Bermuda 170
Comoros 52 Cape Verde 119
Djibouti 50 Cayman Islands 181
Gabon 86 East Timor 44
Guinea 29 French Guiana 151
Kuwait 128 Grenada 136
Lebanon 74 Kiribati 100
Liberia 6 Liechtenstein 183
Mauritania 103 Macao 138
Myanmar 5 Marshall Islands 110
North Korea 13 Martinique 157
Niger 60 Micronesia 91
Paraguay 27 Monaco 161
Qatar 135 Nauru 156
Saudi Arabia 105 Puerto Rico 166
Seychelles 126 Samoa 131
Syria 58 San Marino 171
Tunisia 114 Soa Tome and Principe 102
United Arab Emerites 152 Solomon Islands 43
St. Kitt's and Nevis 127
St. Lucia 129
St. Vincents and the Grenadines 132
Taiwan 160
Tonga 66
Tuvalu 172
Vanuatu 87
West Bank 26
4. BMC International Health and Human Rights 2005, 5:4 http://www.biomedcentral.com/1472-698X/5/4
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1999–2003 were obtained from the Human Develop-
ment Report 2004 whilst military expenditure as a per-
centage of GDP for 2002 were obtained from the
International Institute for Strategic Studies [15].
Results
There were fifty distinct HIV prevalence rankings from the
149 countries with UNAIDS HIV prevalence estimates in
2002. Botswana had the highest HIV prevalence estimates
(38.8%) in the world that year whilst the majority of
countries were placed within the lowest ranking, where
HIV prevalence estimates were reported by UNAIDS to be
< 0.1% (written as 0.05%). The distribution of HIV prev-
alence estimates by mean governance ranking is shown in
Figure 1.
Non-parametric analysis of association between govern-
ance and HIV prevalence is shown in Table 4. The negative
correlations indicate that HIV prevalence falls as the gov-
ernance improves for each governance dimension and
mean governance. The three most influential dimensions
of governance were government effectiveness, the rule of
law and corruption. All correlations were significant thus
rejecting the null hypothesis.
The dataset of 149 nations has been divided into three
groups that represent the lowest (n = 50), middle (n = 50)
and the highest (n = 49) governance ranking positions for
each governance dimension and mean governance in
Tables 5, 6 and 7 respectively. When these nations were
divided into three groups, the median (range) HIV
prevalence estimates remained constant at 0.7% (0.05 –
33.7%) and 0.75% (0.05% – 33.4%) for the lower and
middle mean governance groups respectively despite
improvements in other health and economic indices. The
A scatter graph of Mean Governance Ranking and HIV prevalence for 149 countriesFigure 1
A scatter graph of Mean Governance Ranking and HIV prevalence for 149 countries.
0
5
10
15
20
25
30
35
40
0 20 40 60 80 100 120 140 160 180 200
Mean Governance Ranking
HIVprevalence(%)
5. BMC International Health and Human Rights 2005, 5:4 http://www.biomedcentral.com/1472-698X/5/4
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median HIV prevalence estimates in the higher mean gov-
ernance group was 0.2% (0.05 – 38.8%).
Discussion
It is possible to divide those nations affected by HIV /
AIDS into three groups that approximate to governance
ranking. The higher governance group is characterized by
significant wealth and effective healthcare systems. The
main challenges for these countries consists of the
provision of sexual health services, health care access to
marginalized groups, continuation of education and
research into new and improved prevention and treat-
ment strategies.
The HIV prevalence is generally low in higher governance
group however this figure conceals differences found
Table 4: HIV prevalence correlations for each governance dimension and mean governance
Governance dimension Correlation coefficient (N = 149) p value
Voice & accountability -0.123 0.032
Political Stability and Absence of Violence -0.164 0.004
Government Effectiveness -0.204 0.000
Regulatory Quality -0.157 0.006
Rule of Law -0.194 0.001
Corruption -0.184 0.001
Mean Governance -0.170 0.003
Table 5: HIV, health and development data for the lowest governance ranking group.
Country
Median (Range)
N = 50
2002 HIV
prevalence (%)
MMR (maternal
deaths / 100,000
live births) in
2000
Physicians
(per 100,000),
1990–2003
Improved
drinking water
(%) in 2002
Life Expectancy
(years) in 2002
GDP-PPP ($ per
capita) in 2002
GINI index 1994 –
2001
Ratio Health +
Education / Health
+ Education +
Military Spending in
2002
Voice &
Accountability
1.3 (0.05 – 33.7) 525 (16 – 2000) 25 (1 – 596) 72 (22 – 100) 55.4 (37.1 – 76.4) 1621 (498 – 15650) 37.2 (26.8 – 62.9) 0.62 (0.14 – 0.91)
Political Stability 0.45 (0.05 – 33.7) 340 (7 – 2000) 27 (1 – 463) 77 (22 – 100) 63.1 (37.1 – 78.7) 2201 (498 – 18558) 37.8 (26.8 – 62.9) 0.62 (0.20 – 0.92)
Government
Effectiveness
1.65 (0.05 – 33.7) 570 (7 – 2000) 23.5 (1 – 463) 71 (22 – 100) 54.5 (37.1 – 75.6) 1622 (498 – 8663) 44.1 (26.8 – 62.9) 0.69 (0.20 – 0.91)
Regulatory
Quality
1.0 (0.05 – 33.7) 525 (7 – 2000) 25 (1 – 596) 73 (22 – 100) 56.6 (36.4 – 76.4) 1651 (498 – 12732) 38.2 (26.8 – 62.9) 0.62 (0.17 – 0.90)
Rule of Law 1 (0.05 – 33.7) 415 (7 – 2000) 25 (1 – 596) 74 (29 – 100) 60.4 (36.4 – 76.4) 1771 (498 – 12732) 39.6 (26.8 – 62.9) 0.68 (0.20 – 0.91)
Corruption 1.0 (0.05 – 33.7) 435 (7 – 2000) 26 (1 – 463) 75 (29 – 100) 60.8 (36.4 – 75.6) 1963 (498 – 12732) 39.3 (26.8 – 62.9) 0.70 (0.20 – 0.91)
Mean
governance
0.7 (0.05–33.7) 505 (7 – 2000) 25 (1 – 596) 73 (22 – 100) 59.2 (37.1 – 76.4) 1681 (498 – 12732) 37.2 (26.8 – 62.9) 0.64 (0.14 – 0.91)
Table 6: HIV, health and development data for the middle governance ranking group.
Country
Median (Range)
N = 50
2002 HIV
prevalence (%)
MMR (maternal
deaths / 100,000
live births) in
2000
Physicians
(per
100,000),
1990–2003
Improved
drinking water
(%) in 2002
Life Expectancy
(years) in 2002
GDP-PPP ($ per
capita) in 2002
GINI index 1994 –
2001
Ratio Health +
Education / Health
+ Education +
Military Spending in
2002
Voice &
Accountability
0.45 (0.05 – 31) 130 (5 – 1500) 87 (2 – 463) 84 (39 – 100) 68.5 (36.4 – 79.6) 3383 (693 – 25102) 44 (28.2 – 70.7) 0.77 (0.35 – 0.94)
Political Stability 0.95 (0.05 – 33.4) 180 (10 – 1800) 68 (2 – 596) 85 (34 – 100) 65.4 (36.4 – 77.2) 3544 (675 – 35831) 44.0 (29.0 – 70.7) 0.80 (0.14 – 0.95)
Government
Effectiveness
0.4 (0.05 – 33.4) 130 (2 – 1500) 90 (2 – 596) 85 (41 – 100) 69.1 (36.4 – 77.5) 3596 (675 – 12732) 40.0 (25.8 – 70.7) 0.77 (0.13 – 0.94)
Regulatory
Quality
0.5 (0.05 – 33.4) 150 (5 – 1800) 85 (4 – 420) 84 (34 – 100) 66.9 (37.1 – 77.5) 3481 (770 – 10338) 44.6 (28.2 – 70.7) 0.79 (0.33 – 0.96)
Rule of Law 0.45 (0.05 – 31.0) 145 (2 – 1800) 76 (3 – 344) 84 (22 – 100) 68.0 (37.1 – 77.5) 3384 (595 – 10212) 42.2 (25.8 – 60.7) 0.77 (0.14 – 0.95)
Corruption 0.45 (0.05 – 33.4) 145 (5 – 1400) 68 (2 – 596) 83 (22 – 100) 68.5 (38.6 – 77.5) 3418 (595 – 9575) 43.0 (28.9 – 70.7) 0.77 (0.14 – 0.95)
Mean
governance
0.75 (0.05 – 33.4) 160 (5 – 1800) 75 (2 – 420) 83 (41 – 100) 66.9 (36.4 – 77.5) 3418 (693 – 9575) 44.6 (28.2 – 70.7) 0.79 (0.17 – 0.95)
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within specific population groups. For example in the
USA, HIV prevalence amongst African American women is
almost twenty three times that in whites [16]. Whilst in
the UK, the prevalence of HIV amongst men who have sex
with men (MSM) within London in 2001 was 100 times
the national average [17]. The disparity in HIV prevalence
amongst 'at risk' groups in the UK and US highlight the
general difficulty of using the UNAIDS country HIV prev-
alence estimates. The quality of surveillance methods has
been discussed and graded by UNAIDS surveillance
teams, and it is clear that some HIV prevalence estimates
are inaccurate [18].
Most sentinel surveillance methods use antenatal screen-
ing due to the ease of patient access and the benefits of
provision of anti-retroviral treatment (ART) to prevent
mother to child transmission. This surveillance strategy,
though easier to implement, does not sample high risk
groups such as MSM, intravenous drug users and commer-
cial sex workers and thus underestimates the true HIV
prevalence figure for the country. Within the 2002
UNAIDS HIV prevalence estimates used in this analysis
there are at least four grades of surveillance. As
highlighted in Table 3 some countries / regions were not
included in formal UNAIDS surveillance and then there
are countries where a UNAIDS report was commissioned
yet no HIV prevalence estimate was provided. Reasons
were not given as to why certain countries did not have a
report commissioned. One fifth of the countries with
UNAIDS reports quote a HIV prevalence estimate less
than 0.1% and yet other health and economic indices
would predict that this is an optimistic figure. Finally,
there are those countries that report a HIV prevalence esti-
mate greater than 0.1% which is complicated to varying
degrees by the observer bias described above. Additional
file 1 tabulates the UNAIDS HIV prevalence estimates for
each of the 149 countries included in this analysis.
The governance dataset by Kaufmann et al in 2002 is the
first global assessment of societal structures. These authors
point out the variability inherent in collecting subjective
material and, like UNAIDS, state the need to improve the
quality of the data collected in subsequent analyses. Ide-
ally sources would be able to freely report on each nation
however, the extent of data available decreases in those
nations with poorer governance. The relatively large mar-
gins of error within the governance data make direct cross-
country comparisons difficult to interpret. Due to the var-
iability of both the governance and HIV prevalence data-
set the whole spectrum of data was chosen and subjected
to non-parametric ranking analysis. The null hypothesis
'HIV prevalence is not associated with governance' is
rejected for each dimension of governance with variations
in the relative importance of different governance dimen-
sions. Previously, Fareed Zakaria [19] has argued that
democracy is less important in the development of a
strong nation than the rule of law, corruption and politi-
cal stability. The correlation coefficient of the voice and
accountability dimension of governance with HIV preva-
lence was the lowest in this analysis somewhat supporting
this contention.
Those countries in the lowest governance ranking group
of governance are defined by poverty, ineffective health
care systems, elevated HIV prevalence and significant
international debt. The elevated HIV prevalence in many
of these vulnerable countries was predicted more than a
decade ago following the analysis of health, economic
and human rights data [20]. Historically, international
support has focused on short-term 'vertical' disease con-
trol strategies to tackle healthcare problems [21]. Long-
term, 'horizontal' capacity building strategies are vital if
HIV / AIDS is going to be effective managed in nations
with limited healthcare infrastructure [22]. It has been
shown in a number of resource poor settings that the pro-
vision of voluntary counselling and testing (VCT) for HIV
Table 7: HIV, health and development data for the highest governance ranking.
Country
Median (Range)
N = 49
2002 HIV
prevalence (%)
MMR
(maternal
deaths /
100,000 live
births) in
2000
Physicians (per
100,000), 1990–
2003
Improved
drinking water
(%) in 2002
Life Expectancy
(years) in 2002
GDP-PPP ($ per capita)
in 2002
GINI index 1994
– 2001
Ratio Health +
Education / Health
+ Education +
Military Spending in
2002
Voice &
Accountability
0.2 (0.05 – 38.8) 10 (0 – 730) 287 (25 – 607) 100 (24 – 100) 76.8 (37.1 – 80.8) 15961 (3085 – 35894) 34.2 (24.4 – 63) 0.86 (0.20 – 1.00)
Political Stability 0.2 (0.05 – 38.8) 10 (0 – 850) 278 (5 – 607) 100 (24 – 100) 76.0 (37.1 – 80.8) 15108 (1001 – 35894) 32.7 (24.4 – 63.0) 0.85 (0.20 – 1.00)
Government
Effectiveness
0.2 (0.05 – 38.8) 10 (0 – 420) 269 (5 – 607) 100 (24 – 100) 76.9 (37.1 – 80.8) 17122 (1122 – 35894) 35.3 (24.4 – 63.0) 0.85 (0.20 – 1.00)
Regulatory
Quality
0.2 (0.05 – 38.8) 10 (0 – 730) 279 (25 – 607) 100 (24 – 100) 76.9 (37.1 – 80.8) 17122 (1911 – 35894) 33.1 (24.4 – 63.0) 0.85 (0.20 – 1.00)
Rule of Law 0.2 (0.05 – 38.8) 10 (0 – 730) 269 (29 – 607) 100 (24 – 100) 76.9 (37.1 – 80.8) 17122 (1911 – 35894) 35.3 (24.4 – 70.7) 0.85 (0.20 – 1.00)
Corruption 0.2 (0.05 – 38.8) 10 (0 – 730) 269 (5 – 607) 100 (24 – 100) 76.9 (37.1 – 80.8) 17122 (1122 – 35894) 35.3 (24.4 – 63.0) 0.85 (0.20 – 1.00)
Mean
governance
0.2 (0.05 – 38.8) 10 (0 – 730) 279 (29 – 607) 100 (24 – 100) 76.9 (37.1 – 80.8) 17122 (1911 – 35894) 34.2 (24.4 – 63) 0.85 (0.20 – 1.00)
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is facilitated by the provision of free primary care services
and ART [23]. The provision of effective primary care sup-
port to pregnant women is the most effective way to pro-
vide VCT services for HIV and thereby identify HIV
positive mothers, prevent mother to child transmission
and facilitate VCT of their partner(s). Like surveillance,
this strategy though relatively effective fails to test and
treat vulnerable 'high risk' groups within the population.
The poor are those most at risk of infectious disease. The
role of poverty as a risk factor for disease has been clear for
over 300 years [24]. Health and wealth are inextricably
linked. All who become chronically ill enter a negative
cycle of limited horizons. Indeed, what is true for the indi-
vidual is equally true for the nation state. The effect of HIV
on economic under performance and negative growth is
testament to this. It is vital that essential healthcare is free,
so that those that catch treatable infectious diseases are
allowed to live. Encouragingly there are a few positive
examples in resource poor countries, such as Uganda, Sen-
egal and Cuba, where leadership, good communication
and support of civil society have made a difference in their
respective HIV epidemics. There are however many coun-
tries within this group of vulnerable nations that need the
bulk of international healthcare and financial institution
commitment in order to address their devastating health-
care challenges.
One example is Nigeria which is the most populous
nation in Africa that has been a democracy since 1999.
Despite its vast resource wealth, this country has suffered
from repeated religious and ethnic conflicts that have
compromised its development [25]. Only recently has the
civilian government made HIV / AIDS its top priority and
initiated some selective treatment programs. This change
followed pressure from civil society and the military, in
this latter group HIV prevalence is estimated to be 20%
[26]. In contrast, South Africa is 115 mean governance
ranking points higher than Nigeria, has had universal
franchise for a decade and the per capita wealth is almost
ten times greater than Nigeria yet the HIV prevalence is
four times greater in South Africa. Some of the multiple
factors that help explain the HIV prevalence in South
Africa include: an earlier HIV epidemic, migration from
high HIV prevalence neighbours, the violence and ine-
quality of the Apartheid era and government inaction over
the last decade. The government of South Africa has
recently responded to national and international civil
society pressure and has promised to provide ART free to
all patients with advanced HIV disease [27].
Cuba and Haiti are islands with a similar population size
and GDP-PPP per capita yet the HIV prevalence estimates
are 0.05% and 6.1% respectively. HIV is thought to have
entered Haiti from the USA via the sex trade in the early
1980s. The main exposure risk for Cuban nationals was
from military and healthcare worker interaction with sub-
Saharan Africa. Cuba was one of the first countries in the
Americas to launch a nationwide HIV policy to contain
transmission and care for those people living with HIV /
AIDS [28]. Healthcare in Cuba is provided free to its citi-
zens by the state and there is strong political commitment
supporting health as well as national and international
HIV / AIDS action. In contrast, there have been 33 coups
in Haiti in the last two centuries of independence. Politi-
cal instability in addition to other governance factors have
been attributed to the lack of development of a responsive
healthcare system [29].
As governance improves fewer women die in childbirth,
more physicians exist per population, there is better access
to improved water and life expectancy is longer. In addi-
tion with improvements in governance there is more
GDP-PPP per capita, more equitable distribution of
income and greater investment in health and education
compared to the military. Interestingly, the median HIV
prevalence estimates does not change between the lower
and middle third groups of mean governance ranking
despite a step-wise improvement in all other indices. The
majority of middle ranking economies can be found
within the middle governance group. Many of these coun-
tries have large populations where the HIV epidemics are
set to explode. Three nations in this group who have the
economic and technological power to halt their respective
epidemics are Russia, China and India.
Russia has over 3 million intravenous drug users and rel-
atively expensive ART that help to fuel the HIV epidemic
[30]. The collapse of the USSR produced significant strain
on the health of the people [31]. Life expectancy in Russia
fell 9 years following its transition to a market economy
and there has been a significant rise in 'social diseases' of
Tuberculosis (TB), HIV and Hepatitis. Intravenous drug
use accounts for approximately 80% of those infected
with HIV however recently a new phase of the epidemic
has developed that is driven by sexual transmission [32].
It is only since 2003 that there has been an increase in
leadership and commitment at higher political levels to
combat HIV and AIDS.
UNAIDS reported in 2002 that the number of overall
infections in China increased 30% since 1998, with over
1 million people infected with HIV [33]. It is feared that
China may soon experience an explosive and widespread
HIV epidemic. Intravenous drug use and the sharing of
contaminated needles in the south and north-west of
China was one mechanism of initial transmission the
other was unsafe practices among paid blood donors.
Unsafe blood collections in the 1990s led to the appear-
ance of HIV and subsequent AIDS deaths in Chinas cen-
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tral provinces. In response to this the Chinese authorities
have recently announced that they are providing free ART
in central provinces [34].
The first main focus of HIV in India was Mumbai where
there is a large commercial sex work industry and the HIV
prevalence reported amongst these workers is 50%. It is
expected that HIV will become the largest cause of adult
mortality in India in the coming decade. Despite the gov-
ernment making HIV its national topmost priority, any
attempt to address the problem is hampered by its frac-
tured health care infrastructure, poor literacy figures and
widespread poverty [35]. At the end of 2003 the Indian
government began providing free ART in eight govern-
ment hospitals with the plan to expand it to a total of 25
centres [36].
The aim of this paper was to attempt to dissect out the role
of governance in the HIV pandemic. It is not possible yet
to determine if the relationship seen represents correla-
tion or causation. Even though this first analysis alludes to
causation, for those 149 countries with UNAIDS HIV
prevalence data, the relationship will become clearer over
time when it is possible to compare nations that appear
similar today. Currently Brazil and India have equivalent
overall governance and HIV prevalence estimates at 0.8%
and 0.7% respectively. However when other health and
economic indices are examined it is clear that India invest
less than Brazil in health and education, has one quarter
the number of physicians and double the MMR. The GDP-
PPP per capita is three times greater in Brazil but it is more
equitably distributed in India which is likely to contribute
to equivalent life expectancy seen in both countries. India
and Brazil are the main producers of generic ART. How-
ever Brazil, unlike India, has consistently provided strong
political support for HIV / AIDS patients after the end of
the military dictatorship in 1990. In 1996, the Brazilian
government guaranteed by national law the permanent
allocation of financial resources and universal access to
care, including ART [37]. The current disparities between
India and Brazils HIV treatment policy predicts that the
Indian epidemic will progress more rapidly and is likely to
impact on its development. All ten countries selected for
discussion are summarised in Table 8.
HIV / AIDS control in Russia, China and India will only
be possible if they follow the example set by Brazil. Inter-
national institutions need to support national civil society
groups within these nations to focus the attention and
resources of their respective governments for progressive
healthcare changes. The global plan to stop TB outlines
the possibilities and challenges that will be faced treating
chronic illness, such as HIV [38]. It is pertinent that inter-
national health and financial institutions work together to
influence change so that robust healthcare networks and
responsive government are developed in order to apply
best healthcare and economic practice.
The WHO goal of three million HIV positive persons
being on ART by 2005 would be readily met if civil society
in resource rich countries was able to precipitate progres-
sive societal changes. Health is a fundamental human
right, consequently each global institution, organization
and citizen needs to work towards stable and progressive
societal structures that can facilitate the provision of
healthcare 'access for all'. The current HIV pandemic rep-
Table 8: Ten selected countries through which the relationship of governance and HIV prevalence is discussed.
Country Mean
Governance
Ranking
2002 HIV
prevalence (%)
MMR (maternal
deaths /
100,000 live
births) in 2000
Physicians (per
100,000), 1990–
2003
Improved
drinking water
(%) in 2002
Life Expectancy
(years) in 2002
GDP-PPP ($
per capita) in
2002
GINI index
1994 – 2001
Ratio Health +
Education /
Health +
Education +
Military
Spending in
2002
Haiti 7 6.1 680 25 71 49.3 1824 na 0.73
Nigeria 15 5.8 800 27 60 51.1 924 50.6 0.31b
Cuba 53 0.05 16 596 91 76.4 1717 na 0.79
Russia 65 0.9 45 420 96 67.3 7699 45.6 0.59
China 84 0.1 28 164 77 71.6 3535 40.3 0.33b
India 95 0.8 430 51 86 62.8 2136 37.8 0.65
Brazil 113 0.7 260 206 89 63.2 6477 60.7 0.77
South Africa 130 20.1 230 25 87 48.0 8466 59.3 0.85
United States 179 0.6 11 279 100 77.2 35831 40.8 0.78
United
Kingdom
187 0.1 8 164 100 77.8 22801 36.0 0.82
b = no education expenditure data
na = not available
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resents collective inaction and indifference towards global
health. The promotion of good governance is a necessary
step to enable national civil society to engineer long-term
healthcare changes to deal with HIV / AIDS and future
healthcare challenges.
Conclusion
Using World Bank governance data and UNAIDS HIV
prevalence estimates for 2002 this paper tests the hypoth-
esis 'HIV prevalence is not associated with governance'.
Additional health and economic indices are used to high-
light the development needs for each country. The accu-
racy of both governance and HIV prevalence estimates are
discussed and some country comparisons are made. HIV
prevalence is significantly associated with poor govern-
ance. International public health programs need to
address societal structures in order to create strong foun-
dations upon which effective healthcare interventions can
be implemented.
Competing interests
The author(s) declare that they have no competing
interests.
Authors' contributions
ASM-J designed the study, performed statistical analysis
and wrote the manuscript. The author read and approved
the final manuscript.
Additional material
Acknowledgements
I would like to thank everybody who provided feedback and support for
this work.
References
1. Sen A: Development as Freedom. In Chapter 7: Famine and other
crises Oxford University Press; 2001. ISBN: 0192893300
2. World Health Organisation: Macroeconomics and Health:
Investing in Health for Economic Development. 2001 [http://
www.who.int/macrohealth/en/].
3. United Nations Development Programme: Human Development
Report 2003. Millennium development goals: A compact
among nations to end human poverty. Oxford University Press.
4. The World Bank Group: Millennium development goals. [http:/
/www.developmentgoals.org].
5. Easterly W: The Elusive Quest for Growth. MIT press; 2002.
ISBN: 0-262-55042
6. Farmer P: Infections and Inequalities. Berkeley, University of Cal-
ifornia Press; 1999. ISBN: 0-520-22913-4
7. World Health Organisation: World Health Report 2004. Chang-
ing History. [http://www.who.int/whr/en/].
8. Kaufmann D, Kraay A, Mastruzzi M: Governance Matters III: Gov-
ernance Indicators for 1996–2002. World Bank Policy Research
Working Paper 3106 2003.
9. World Bank Group: Governance Matters III: Governance Indi-
cators for 1996–2002. [http://info.worldbank.org/governance/
kkz2002/tables.asp].
10. WHO, UNICEF and UNFPA: Maternal Mortality in 2000: Esti-
mates developed by WHO, UNICEF and UNFPA. [http://
www.who.int/reproductive-health/publications/
maternal_mortality_2000/].
11. United Nations Development programme: Human Development
report 2004. [http://hdr.undp.org/reports/global/2004/].
12. WHO: WHO/UNICEF Joint Monitoring Programme for
Water Supply and Sanitation; Meeting the MDG drinking
water and sanitation target: a mid-term assessment of
progress, 2004. . ISBN 92 4 156278 1
13. Central Intelligence Agency: The World Factbook 2004. [http://
www.cia.gov/cia/publications/factbook/index.html].
14. United Nations Development Programme: Inequality in Income
or consumption. Human Development Indicators 2003.
15. International Institute for Strategic Studies: The Military Balance
2004–2005. Oxford University Press; 2004. ISSN 0459-7222
16. Centre for Disease Control: HIV/AIDS among African
Americans. 2002 [http://www.cdc.gov/hiv/pubs/Facts/afam.htm].
17. Health Protection Agency: HIV and other Sexually Transmitted
Infections in the United Kingdom in 2003. Annual Report 2004
[http://www.hpa.org.uk/infections/topics_az/hiv_and_sti/publications/
annual2004/annual2004.htm].
18. Garcia-Calleja JM, Zaniewski E, Ghys PD, Stanecki K, Walker N: A
global analysis in trends in the quality of HIV sero-surveil-
lance. Sex Transm Infect 2004, 80(Suppl 1):i25-i30.
19. Zakaria F: The Future of Freedom. W.W.Norton & company,;
2003. ISBN: 0-393-04764-4
20. Mann JM, Tarantola DJ, Netter TW: AIDS in the World. In Chapter
14: Assessing vulnerability to HIV Infection and AIDS Harvard University
press; 1992. ISBN0-674-01265-8
21. Tan DHS, Upshur REG, Ford N: Global plagues and the Global
Fund: Challenges in the fight against HIV, TB and malaria.
BMC International Health and Human Rights 2003, 3: [http://
www.biomedcentral.com/1472-698X/3/2].
22. Scalway T: Missing the Message? 20 years of learning from HIV
/ AIDS. [http://www.panos.org.uk/global/reportdown
load.asp?type=report&id=1001&reportid=1066]. Panos ISBN 1
87067065 5
23. Partners in Health: The PIH Guide to the Community-Based
Treatment of HIV in Resource-Poor Settings. XV International
AIDS Conference, Bangkok Edition. Partners in Health 2004 [http://
www.pih.org/library/aids/index.html]. ISBN: 0-9744222-1-5
24. Dale P: Sir WP of Romsey. LVTAS Group 1987. ISBN 0-906921-05-8
25. UNAIDS: National Response Brief on Nigeria 2002. [http://
www.unaids.org/nationalresponse/search.asp].
26. Elbe S: HIV / AIDS and the changing landscape of war in
Africa. International Security 2002, 27:159-177.
27. Plus News: SOUTH AFRICA: Chronology of HIV/AIDS treat-
ment plan, August 2003 to April 2004. The HIV / AIDS news serv-
ice [http://www.plusnews.org/
AIDSreport.asp?ReportID=3219&SelectRegion=Africa]. 1st April,
2004
28. Farmer P: The Pathologies of Power. University of California
Press; 2003. ISBN: 0520235509
29. Farmer P: Political Violence and Public Health in Haiti. NEJM
2004, 350:1483-1486.
30. UNAIDS: Report on the global AIDS epidemic 2004. [http://
www.unaids.org].
31. Garrett L: Betrayal of Trust: The Collapse of Global Public
Health. Oxford University Press; 2001. ISBN: 0198509952
32. UNAIDS: National Response Brief on Russia. 2002 [http://
www.unaids.org/nationalresponse/search.asp].
33. UNAIDS: National Response Brief on China. 2002 [http://
www.unaids.org/nationalresponse/search.asp].
34. Xinhau News Agency: Guangdong to offer free HIV / AIDS
treatment. . 31st May, 2004
35. Editorial: Political neglect in India's health. The Lancet 2004,
363:1565.
Additional File 1
Submitted Governance and Health additional file. Tabulates 149 coun-
tries by their governance ranking, HIV prevalence, health and economic
data.
Click here for file
[http://www.biomedcentral.com/content/supplementary/1472-
698X-5-4-S1.doc]
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(page number not for citation purposes)
36. National AIDS Control Organization: Anti-retroviral Treatment:
A new initiative. 2003 [http://www.nacoonline.org/
directory_arv.htm].
37. UNAIDS: National Response Brief on Brazil. 2002 [http://
www.unaids.org/nationalresponse/search.asp].
38. World Health Organisation: Progess Report on the global plan
to Stop Tuberculosis. 2004 [http://www.stoptb.org/documents/
progress_report_2004.pdf].
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