High-quality health systems in the Sustainable Development Goals era: time for a revolution

OBJECTIVE Despite the importance of diabetes for global health, the future economic consequences of the disease remain opaque. We forecast the full global costs of diabetes in adults through the year 2030 and predict the economic consequences of diabetes if global targets under the Sustainable Development Goals (SDG) and World Health Organization Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020 are met. RESEARCH DESIGN AND METHODS We modeled the absolute and gross domestic product (GDP)-relative economic burden of diabetes in individuals aged 20–79 years using epidemiological and demographic data, as well as recent GDP forecasts for 180 countries. We assumed three scenarios: prevalence and mortality 1 ) increased only with urbanization and population aging (baseline scenario), 2 ) increased in line with previous trends (past trends scenario), and 3 ) achieved global targets (target scenario). RESULTS The absolute global economic burden will increase from U.S. $1.3 trillion (95% CI 1.3–1.4) in 2015 to $2.2 trillion (2.2–2.3) in the baseline, $2.5 trillion (2.4–2.6) in the past trends, and $2.1 trillion (2.1–2.2) in the target scenarios by 2030. This translates to an increase in costs as a share of global GDP from 1.8% (1.7–1.9) in 2015 to a maximum of 2.2% (2.1–2.2). CONCLUSIONS The global costs of diabetes and its consequences are large and will substantially increase by 2030. Even if countries meet international targets, the global economic burden will not decrease. Policy makers need to take urgent action to prepare health and social security systems to mitigate the effects of diabetes.

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Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(19)32540-1.pdf

A future for the world's children? A WHO-UNICEF-Lancet Commission

Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher–Lancet Commission

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(18)32114-7.pdf

The UCL–Lancet Commission on Migration and Health: the health of a world on the move

Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries

When used correctly and consistently, the male condom offers triple protection from unintended pregnancy and the transmission of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) However, with health funding levels stagnant or falling, it is important to understand the cost and health impact associated with prevention technologies This study is one of the first to attempt to quantify the cost and combined health impact of condom use, as a means to prevent unwanted pregnancy and to prevent transmission of STIs including HIV This paper describes the analysis to make the case for investment in the male condom, including the cost, impact and cost-effectiveness by three scenarios (low in which 2015 condom use levels are maintained; medium in which condom use trends are used to predict condom use from 2016-2030; and high in which condom use is scaled up, as part of a package of contraceptives, to meet all unmet need for family planning by 2030 and to 90% for HIV and STI prevention by 2016) for 81 countries from 2015-2030 An annual gap between current and desired use of 109 billion condoms was identified (46 billion for family planning and 63 billion for HIV and STIs) Under a high scenario that completely reduces that gap between current and desired use of 109 billion condoms, we found that by 2030 countries could avert 240 million DALYs The additional cost in the 81 countries through 2030 under the medium scenario is $19 billion, and $275 billion under the high scenario Through 2030, the cost-effectiveness ratios are $304 per DALY averted for the medium and $115 per DALY averted for the high scenario Under the three scenarios described above, our analysis demonstrates the cost-effectiveness of the male condom in preventing unintended pregnancy and HIV and STI new infections Policy makers should increase budgets for condom programming to increase the health return on investment of scarce resources

/pdf/the-case-for-investing-in-the-male-condom-4m8nnqzch5.pdf

James E. Rosen

Papers

Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries

The case for investing in the male condom