Combining health and social protection measures to reach the ultra ...

More documents

Recommendations

Info

Research resources1,61001,41,21908070600,8500,60,40,24030201001994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006MorbidityCoverture0Figure 4: Incidence and vaccination coverage by Haemophilus influenzae type b, in the period 1994–2006Scientific research in this field has enabled the country tobecome currently self-sufficient, with the production of 527drugs including the antiretroviral, anticancer andimmunosupressive drugs supporting the nationalprogrammes of HIV/AIDS, control of cancer and organtransplantation. Monoclonal antibodies, of wide application innephrology and oncology, human transference factor andgrowth factor used in the treatment of cancer, proctitis andulcers, and Surfacen for the treatment of respiratory distressof newborn are also included in the range of Cuban products.UltramicroELISA, a Cuban diagnostic technology forneonatal and infectious disease screening, is widely used inthe country, supporting the epidemiological surveillance ofseveral infectious diseases such as dengue, HIV, HBV andHCV and the screening in all pregnant women of neonataldisorders such as congenital hypothyroidism, phenylketonuria,galactosemia and other malformations. In the period 1982 to2006, more than 3 million pregnant women were screenedand 6748 congenital malformations were detected .24 . Also,more than 2.7 million (100%) of newborns were studied,detecting 731 with congenital hypothyroidism. Thesechildren were treated early, avoiding cretinism.UltramicroELISA has also been fundamental for the bloodcertification programme.A relatively recent national investigation allowed screeningof all individuals with some disability. The physical andpsychological characteristics of these persons and thecontributing factors for intellectual or mental disability weredetermined. In the Medical Genetic services, extended to allprovinces of the country as part of the National Programmeof Attention to Persons with Some Disability and theprogramme of Medical Genetics, 29 genetic pathologies andmore than 50 metabolic disorders are diagnosed. Severalinvestigations relative to schizophrenia and Alzheimerdisease, among others, are under way.The development of advanced technology medicalBCGHBDTwP - HB + HibAM-BCMMRDTwPHibDTAT(Vi)TTOPV (campaign)Table 1: Cuban immunization programmeRESEARCH (22)CholeraTuberculosisAdjuvantN. meningitides BMalariaLeishmaniaShiguella-SalmonellaLeptospiraPertussis acellularPseudomonasAnimal modelsMonoclonal antibodiesHIV/AIDSDengue8 Cancer vaccinesDEVELOPMENT (13)Cholera attenuatedDT, dT y t(reduced doses)Poli ACYW135Poli ACdT - Poli ViBCG intra vesicalVA-MENGOC- BC ®reduced aluminumVME as productCholera inactivatedAdjuvant CocleatoNeumococoHC therapeuticHB therapeuticNewbornNewborn2, 4 & 6 months3 & 5 month1 & 6 years18 months18 months6 years10, 13 & 16 years14 years
Research resourcespoliomyelitis and given the particular success of the Cubanvaccination strategy, several investigations supporting globalpolio eradication have been conducted in our country at therequest of the World Health Organization (WHO) and thePan American Health Organization (PAHO), allowingdemonstration of the circulation-time of the vaccine viruses inthe environment after the oral vaccination and the immunityof the inactivated vaccine. This new knowledge and theinvestigations in course will allow improved definition of thestrategy for global polio vaccination after eradication 25 . Newfindings of global impact related to dengue hemorrhagic fever(DHF), have been reported by Cuban scientists. Theconfirmation of secondary infection as a risk factor for DHF,the influence of the interval between infections and the roleof ethnicity and chronic diseases are only some examples 20 .Flexibility also characterizes Cuban science, allowingincorporation of new topics in the research agenda dependingon the epidemiological national and international situation.The preparation of the country in terms of surveillance,diagnosis and research to face new global epidemics such asWest Nile Fever, SARS and Avian Flu are recent examples.Current research needs and agendaAt present, the Cuban population shows a very high healthlevel with the Millennium Development Goals alreadyaccomplished 26,27,28 . However, the country is working to reachnew goals, with an infant mortality ratio of less than fivedeaths per 1000 live births, life expectancy at birth of 80years and quality of life improvement being the mostimportant new targets. At this new stage, research occupiesa leading place due to its direct impact on healthdevelopment. To achieve these new goals, differentinvestigations are under development, notable ones beingactive screening of risk groups and of the open population fordiseases that are the major causes of mortality. Theseinvestigations will allow early detection of the illness in orderto apply the appropriate treatment and management ofpatients, avoiding disability and death. Supporting this newstrategy, the accessibility of the health system has increasedby the introduction of advanced technology at the primaryheath care level.A totally different health picture is observed in many otherpoor countries. According to WHO, and as an example, Africashows an infant mortality per 1000 live births of 100, a lifeexpectancy at birth of 47 years for males and 49 for females,and HIV/AIDS and TB constitute major causes ofmortality 29,30,31 . Due to this serious situation, a new agenda forresearch and the implementation of research findings isneeded at the global level. In this sense, Cuba is developinga new model of regional and international cooperation inhealth, education and science. Currently, the country hosts22 000 students from developing countries in its medicalschools and more than 32 000 Cuban collaborators labour inmore than 80 countries. From the 1960s, more than132 000 health workers collaborated in 102 countries of thedeveloping world. This model of collaboration is having adirect impact on strengthening human capacities, thedevelopment of scientific research and public health. ❏Gustavo Kourí is a researcher, professor and Vice-President ofthe Cuban Academy of Science. He is also Director General of theInstituto Medicina Tropical Pedro Kourí in Havana, Cuba.María G Guzmán is a researcher, professor and Director of theWHO/PAHO Collaborative Centre for Dengue study and its vector.She is Chief of the Virology Department at the Instituto MedicinaTropical Pedro Kourí in Havana, Cuba, and is a Member of theCuban Academy of Science.José Luis Pelegrino is a researcher, professor and a Master inVirology. He is also a research coordinator and a member of staffof the WHO/PAHO Collaborator Centre for Dengue and its vector.He is also on the staff of the Instituto Medicina Tropical PedroKourí in Havana, Cuba.Alicia Reyes is an economist and Vice-Director of the InstitutoMedicina Tropical Pedro Kourí in Havana, Cuba.Luis Estruch is a researcher, professor and epidemiologist,Cuban Ministry of Health.Niviola Cabrera is a professor and National Director for Scienceand Technology, Cuban Ministry of Health.114 ✜ Global Forum Update on Research for Health Volume 4
Page 3 and 4:
Editorial Advisory Board:Luis Gabri
Page 5 and 6:
Contents096 Child immunization: acc
Page 7 and 8:
IntroductionResearch contributions
Page 9 and 10:
IntroductionType IType IIType IIIPr
Page 11 and 12:
Introductionmaking), takes account
Page 13:
Access to healthStrengthening healt
Page 16 and 17:
Access to healthTraining more healt
Page 18 and 19:
Access to healthimperative for acti
Page 20 and 21:
Access to healthReferences1.Further
Page 22 and 23:
Access to healthDeterminantsAvailab
Page 24 and 25:
Access to healthThe authors are inv
Page 26 and 27:
Access to healthCombining health an
Page 28 and 29:
Access to health100%Availability of
Page 30 and 31:
Access to healthhypothesis that an
Page 32 and 33:
Access to healthMandatory clinical
Page 34 and 35:
Access to healthWhile there are som
Page 36 and 37:
Access to healthItemDefinition/Expl
Page 38 and 39:
Access to healthReferences continue
Page 40 and 41:
Access to healthintegrating individ
Page 42 and 43:
Access to healthA social determinan
Page 44 and 45:
Access to healthemployment conditio
Page 46 and 47:
Access to healthMaking human rights
Page 48 and 49:
Access to healthResources outsideth
Page 50 and 51: Access to healthReferences1.McCoy D
Page 52 and 53: Access to healthand financial burde
Page 54 and 55: Access to healthDiscrimination as a
Page 56 and 57: Access to health“Two months ago I
Page 58 and 59: Access to healthReferences continue
Page 60 and 61: Access to healthsocio-cultural and
Page 62 and 63: Access to healthIntergovernmental P
Page 64 and 65: Access to healthand conference stat
Page 66 and 67: Access to healthReferences continue
Page 68 and 69: InnovationTowards the development o
Page 70 and 71: InnovationMajor classificationMajor
Page 72 and 73: Innovation60% of enterprises5040302
Page 74 and 75: InnovationUsing the power ofintelle
Page 76 and 77: Innovationbe adapted - and harnesse
Page 78 and 79: InnovationFinancing of vaccine R&D-
Page 80 and 81: InnovationFinancing Ultimate Interm
Page 82 and 83: Innovationsome of this risk might b
Page 84 and 85: InnovationChild immunization:accele
Page 86 and 87: Innovationare revealing previously
Page 88 and 89: InnovationDeveloping countries % De
Page 90 and 91: Innovationcapacities. It is indeed
Page 92 and 93: InnovationSome plausible causes of
Page 94 and 95: Innovationwhere he was a programme
Page 96 and 97: Research resourcesResearch impact o
Page 98 and 99: Research resourcesBiotechnologists6
Page 102 and 103: Research resourcesReferences1.The R
Page 104 and 105: Research resources✜ A group of nu
Page 106 and 107: Research resourcesReferences1.Inter
Page 108 and 109: Research resourcesThe threat of pan
Page 110 and 111: Research resourcesChanging environm
Page 112 and 113: Research resourcesPartnerships offe
Page 114 and 115: Research resourcesWe encourage othe
Page 116 and 117: Research resources181614No. of PPPs
Page 118 and 119: Research resources12010080604020Pro
Page 120 and 121: Research resourcesCapacity strength
Page 122 and 123: Research resourcestreatment is prov
Page 124 and 125: Research resourcesSmall scale busin
Page 126 and 127: Research resourcesthis process in a
Page 128 and 129: Research resourcesways. For instanc
Page 130 and 131: Decision-making148 Delivering evide
Page 132: Decision-makingChallenges in employ
Page 136 and 137: Decision-makingUsing evidence forpo
Page 138 and 139: Decision-makingdesire to publish. T
Page 140 and 141: Decision-makingsystems development.
Page 142 and 143: Decision-makingTowards evidence-inf
Page 144 and 145: Decision-making✜ develop a critic
Page 146 and 147: Decision-makingwas prior to 2001, a
Page 148 and 149: Decision-makingGlobal and regional
Page 150 and 151:
Decision-makingHigh-incomeChildrenE
Page 152 and 153:
Decision-makingLow- and middle-inco
Page 154 and 155:
Decision-makingLow- and middle-inco
Page 156 and 157:
Decision-makingthan a quarter of th
Page 158 and 159:
Decision-makingThe potentials of in
Page 160 and 161:
Decision-makingGenerally, any resea
Page 162 and 163:
Decision-makingReferences1.Hawes H.
show all

Combining health and social protection measures to reach the ultra ...

Create successful ePaper yourself

Delete template?

Save as template?