The World Bank pioneered global HIV and AIDS financing early in the emergency and remains committed to achieving Millennium Development Goal 6, to halt by 2015 and begin to reverse the spread of HIV and AIDS, through prevention, care, treatment, and mitigation services for those affected by HIV and AIDS.
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Report assesses health loss from combined impact of road injuries, vehicle pollutionLONDON, MARCH 31, 2014 - Safer and cleaner road transport is critical for achieving health and development goals aro... Show More +und the world, according to a new report that --for the first time--assesses the global health loss from the combined impact of road injuries and pollution that can be attributed to motorized transport.Entitled “Transport for Health: the Global Burden of Disease from Motorized Road Transport”, the report was prepared by the World Bank-led Global Road Safety Facility and the Institute for Health Metrics and Evaluation at the University of Washington, along with contributions from authors of other institutions. Findings of the report were discussed today in London at an event hosted by the Overseas Development Institute.Building on previous Global Burden of Disease (GBD) studies, the report breaks new ground by quantifying the health impacts from injuries due to road traffic crashes over the last two decades, and air pollution from vehicles. Findings show injuries and pollution from vehicles contribute to six of the top 10 causes of death globally. Combined with the health losses from vehicle pollution, the road transport death toll exceeds that of HIV/AIDS, tuberculosis, malaria, or diabetes, based on GBD data.The report also highlights the growth in road deaths and injuries globally, and their substantial impacts on maternal and child health. Road crashes, for instance, result in 1.3 million deaths annually and 78.2 million nonfatal injuries warranting medical care. Road injury also is among the 10 leading causes of death in children ages 1 through 14, and among women ages 15 to 44.“That is a powerful wake-up call.…These alarming findings underscore the urgent need to spread improvements in transport pollution and safety across world regions,” writes World Bank Group President Jim Yong Kim in the foreword to the report. “Road crashes cost an estimated 1 to 5 percent of GDP in developing countries, undermining efforts to reduce poverty and boost shared prosperity.”“Transport for Health” calls for increased collaboration of the transport, health, and urban sectors, among others, to achieve sustainable transport and health policies, noting that the benefits of road safety and air quality improvements outweigh their costs, thus making a compelling case for urgent action."Health officials are typically viewed as the chief stewards of countries’ population health, but reducing the burden of disease from motor vehicles requires action from multiple sectors,” says Christopher Murray, director of the Institute for Health Metrics and Evaluation. “As demand for cars and roads increases, the transport sector plays a vital role in designing, building, and maintaining an infrastructure and regulatory system that encourage economic growth while minimizing health loss.”The report describes how the health burden associated with road transport spreads with economic growth and rapid motorization, and notes that mitigating this risk requires a long-term investment strategy to build the capacity of national institutions so they can better manage safety and mobility performance.“Transport for Health” also highlights the need to improve statistical systems that collect information necessary to evaluate the health impacts of road transport. The absence of reliable accounting of health effects not only endangers effective action across sectors, but can also waste government resources or development aid funding targeted at ineffective interventions.The report comes at a time when the UN Decade of Action for Road Safety, launched in 2011, aims to bring under control the growing burden of road traffic injuries, saving some 5 million lives around the world by 2020. The findings of this and other reports confirm the need for urgent support to this development priority.The report also follows a multilateral commitment, at the last Rio +20 meeting, to encourage “sustainable transport” as vital for future global health, particularly addressing issues like increased road transport emissions.Some of the key conclusions from the report include:Deaths from road transport exceed those from HIV, tuberculosis, or malaria.Injuries and pollution from vehicles contribute to six of the top 10 causes of death globally.Health loss attributable to motorized road transport exceeds that from key risk factors affecting children, including suboptimal weight and breastfeeding.Road injuries rank among the top 10 causes of death after the first year of life through age 59. In addition, road injuries are a top-10 cause of death among women of childbearing age and are the fourth-leading cause among women aged 15 to 29 years.While the burden of road injuries is highest in poorer regions, such as sub-Saharan Africa, health loss due to vehicular pollution tends to be highest in richer regions, such as Western Europe.Road crashes result in 1.3 million deaths annually and 78.2 million nonfatal injuries warranting medical care.Over the last two decades, deaths due to road crashes grew by 46%. And deaths attributable to air pollution, to which motor vehicles are an important contributor, grew by 11%.Pedestrians alone account for 35% of road injury deaths globally, and over 50% in East and Central sub-Saharan Africa.Official government statistics substantially underreport road injuries. For example, GBD estimates of road injury deaths are more than twice the official statistics in India, four times those in China, and more than six times the official numbers in parts of Africa.In addition to the World Bank and IHME, the “Transport for Health” report is the result of a broad collaboration by lead authors of various institutions, including: Johns Hopkins Bloomberg School of Public Health; Health Effects Institute; University of British Columbia; Schneider Institute for Health Policy; and Health Canada Show Less -
Kuala Lumpur---Malaysia is combating an epidemic of HIV infections transmitted through sharing contaminated needles and syringes. In 2006, the government initiated limited programs of "harm reduc... Show More +tion" interventions. The program included the Needle and Syringe Program (NSP), a program where people who inject drugs are offered clean needles and syringes, and Methadone Maintenance Therapy (MMT), a program offering heroin addicts enrollment in rehabilitation therapy where heroin is replaced with synthetic methadone. These harm reduction programs have succeeded, and Malaysia has now expanded them nationwide.These harm reduction interventions also have been shown to be cost-effective, according to new research led by the Centre of Excellence for Research in AIDS (CERiA) at the University of Malaya, in collaboration with the Kirby Institute, University of New South Wales and funded by the World Bank. Such interventions can be expected to avert 23,241 new HIV infections as well as result in savings of RM210 million in direct health care costs – producing a return of RM1.07 for every ringgit spent over the next ten years.The study estimated that 12,653 HIV infections were successfully averted since 2006 with the implementation of these NSP and MMT harm reduction programmes, targeting people who inject drugs. These averted infections have resulted in savings of RM47.1 million in direct health care costs, which the government would have had to spend on treatment and monitoring, demonstrating that harm reduction programmes in Malaysia are highly cost-effective.Continuing support for harm reduction would produce even higher returns over the next ten years. The savings in healthcare are expected to increase four-fold which will exceed total investment by RM1.07 for every ringgit spent. It is also expected that harm reduction programmes will continue to be cost-effective and help prevent more than 23,000 new infections.A long term benefits projection for the period 2006-2050 indicates savings of approximately RM910 million in healthcare costs and an average return of RM1.13 for every ringgit invested in harm reduction programmes. This study provides strong evidence that even with the present programme coverage, harm reduction programmes are cost-effective and are expected to produce net cost-savings to the government in the future. Continued support for these programs will save money and save lives.The Government of Malaysia has provided a considerable amount of resources and efforts to control HIV transmission among people who inject drugs with the implementation of the MMT and NSP. Funding for harm reduction activities is almost exclusively from the public purse although more recently it has been supplemented by funding from the Global Fund for AIDS, TB and Malaria and the International HIV/AIDS Alliance. A total of 34,244 people have been enrolled into the NSP which is being conducted by local non-governmental organizations and the Ministry of Health. The MMT program is currently being provided through public hospitals and clinics, private practitioners, and Malaysia’s National Anti-Drug Agency (NADA)’s Cure&Care clinics and Cure&Care Service Centers, as well as in prisons.This study is the first of its kind to review the cost-effectiveness and return on investment of Malaysia’s HIV prevention interventions.According to Ulrich Zachau, World Bank’s Country Director for Malaysia: “We would like to congratulate the Malaysian Government for taking the lead in implementing these cost-effective and cost-saving harm reduction interventions targeting people who inject drugs. These interventions help protect many vulnerable people in Malaysia from HIV infection and save lives. We hope this study will inspire policymakers in other countries in the Asia-Pacific region that face similar HIV epidemics among people who inject drugs.”"This is a very important study that validates what we have always known – that harm reduction programs save lives and money”, says Professor Adeeba Kamarulzaman, Director of CERiA and the Dean of the Faculty of Medicine, University of Malaya. “With injecting drug use continuing to be a significant driver of the HIV epidemic here in Malaysia and in many parts of the region, this study affirms that needle syringe and methadone maintenance programs must remain as a cornerstone in our fight against HIV”, she adds. “We would like to thank and congratulate Dato’ Seri Najib Tun Razak, our Prime Minister who in his capacity as the Chair of the Cabinet Committee on Drugs in 2005 took the bold step to give the go ahead for the implementation of these programs against much public opposition.”The report, titled Cost-Effectiveness and Return on Investment of HIV Harm Reduction Programmes for People Who Inject Drugs in Malaysia, forms part of the World Bank’s technical assistance to Malaysia under Malaysia AIDS Support II project (P133134). The project aims to help Malaysia improve strategic information and generate evidence that will support and strengthen the country’s HIV prevention efforts.Authors:Herlianna Naning, Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;Cliff Kerr, Kirby Institute, University of New South Wales, Sydney, Australia;Adeeba Kamarulzaman, Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;Maznah Dahlui, Social and Preventive Medicine Department, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;Ng Chiu Wan, Social and Preventive Medicine Department, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;David Wilson, Kirby Institute, University of New South Wales, Sydney, Australia;and Sutayut Osornprasop, World Bank Group Show Less -
Collaboration to accelerate progress on global health goals WASHINGTON, December 11, 2013–The World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria announced today a new partnership t... Show More +o support select countries to expand access to essential health services for women and children through results-based financing (RBF) and accelerate progress on Millennium Development Goals (MDGs) 4—reducing child mortality and 5—improving maternal health.Specifically, this partnership will identify opportunities to enable the inclusion of HIV/AIDS, malaria and TB services in RBF projects funded by the World Bank’s International Development Association (IDA) and the World Bank-managed Health Results Innovation Trust Fund (HRITF) focusing on the integration of services; scale up existing RBF programs to cover larger geographical areas for greater reach and impact; and collaborate to ensure a more effective supply chain for essential health commodities to reach the populations most in need.This partnership follows on World Bank Group President Jim Yong Kim’s September 2013 announcement of $700 million in additional results-based financing from IDA for MDGs 4 and 5,as well as the recent Global Fund replenishment."Evidence shows that results-based financing has a significant impact – saving lives and expanding access to quality, essential health services for the poorest women and children in developing countries,” says Jim Yong Kim, President of the World Bank Group.“The World Bank is pleased to partner with the Global Fund to help countries scale up these successful programs.”Since 2007, the HRITF has supported 36 RBF programs in 31 countries, committing $404 million of donor funding from the Governments of Norway and the United Kingdom, which is co-financing $1.6 billion from IDA. About 75% of HRITF funding supports programs in sub-Saharan Africa, which bears over half the global burden of maternal mortality. Data from implementing IDA and HRITF-supported programs around the world show that RBF approaches are increasing coverage and quality of key maternal and child health services and also making country health systems more efficient, and more accountable.“We are working with countries and partners such as the World Bank to accelerate gains in the fight against AIDS, tuberculosis and malaria," said Mark Dybul, Executive Director of the Global Fund. “Results-based financing is an integral part of our approach of investing for maximum impact.”The Global Fund has introduced a new funding model designed to make more effective grants, with greater impact, so that more people can benefit from prevention, care and treatment of AIDS, TB and malaria.The new collaboration will identify opportunities for the scale up of successful RBF programs to increase the geographical coverage of programs as well as expand the package of maternal and child health services.The Global FundThe Global Fund is an international financing institution that fights AIDS, tuberculosis and malaria with a 21st century approach: partnership, transparency, constant learning and results-based funding.Programs supported by the Global Fund in more than 140 countries, as of December 2013, have 6.1 million people on antiretroviral therapy for AIDS, have tested and treated 11.2 million people for TB, and have distributed 360 million insecticide-treated nets to protect families against malaria.The World Bank Group and Health, Nutrition, and PopulationThe World Bank Group is a vital source of financial and technical assistance to developing countries around the world, with the goals of ending extreme poverty and boosting shared prosperity. Improving health is integral to achieving these goals. The World Bank Group provides financing, state-of-the-art analysis, and policy advice to help countries expand access to quality, affordable health care; protect people from falling into poverty or worsening poverty due to illness; and promote investments in all sectors that form the foundation of healthy societies. The World Bank Group is trustee and a board member of the Global Fund. Show Less -
WASHINGTON, November 21, 2013 – World Bank Group President Jim Yong Kim issued the following statement today upon receiving the Prince Mahidol Award:“I am deeply honored to have been selected as one o... Show More +f the four recipients of the Prince Mahidol Award this year for my past work on HIV/AIDS. I extend my congratulations to the other three recipients: Dr. David Ho, Dr. Anthony Fauci, and Dr. Peter Piot.The award reflects a turning point in the history of HIV/AIDS when the agenda transformed from one of despair to one of opportunity with the advent of anti-retroviral medicines and the mobilization toward access of life-saving drugs to everyone, no matter their background or economic status.The World Health Organization’s 3 by 5 effort demonstrated the importance of setting time-bound measurable targets as a stimulus to achieving results more quickly. It is by no means specific to HIV/AIDS and can and should be extended to development more broadly as seen in the new goals of the World Bank Group: ending extreme poverty by 2030 and boosting shared prosperity for the bottom 40 percent of the population in developing countries.In accepting this award, I want to pay tribute to all the AIDS activists whose brilliance and complete dedication to saving lives helped bring us to this point today, where access to medicine should be given to all and we are striving for an AIDS-free generation.” Show Less -
Policy Interventions Can Turn the Tide, Says World Bank ReportWASHINGTON, November 20, 2013 – A new World Bank report warns that risky behaviors –smoking, using illicit drugs, alcohol abuse, unhealthy... Show More + diets, and unsafe sex— are increasing globally and pose a growing threat to the health of individuals, particularly in developing countries. The report looks at how individual choices that lead to these behaviors are formed and reviews the effectiveness of interventions such as legislation, taxation, behavioral change campaigns, and cash transfers to combat them.Risking your Health: Causes, Consequences and Interventions to Prevent Risky Behaviors concludes that legislation and taxation, for example, tend to be effective, especially when combined with strong enforcement mechanisms. Cash transfers also have proven to be promising in some settings. Behavior change campaigns, such as school-based sex education and calorie-labeling laws, are often less effective on their own, unless they are complemented with broader risk behavior change programs.“Risky behaviors not only endanger an individual’s health and reduce life expectancy, they often impose consequences on others,” said Damien de Walque, Senior Economist in the World Bank’s research department and principal editor of the report. “The health consequences and monetary costs of risky behaviors to individuals, their families, and society as a whole are staggering and justify public interventions.”The report finds that despite recent progress in prevention and treatment, the HIV/AIDS epidemic —one of the most devastating consequences of risky sex— remains a heavy burden in Sub-Saharan Africa, especially in its southern cone where between 11 and 26 percent of all adults are HIV positive. Drug and alcohol abuse have been relatively stable over the past decade, but smoking and obesity linked to unhealthy diets are on the rise in many developing countries and have the potential to substantially increase mortality and morbidity. Close to 20 percent of the world’s adult population smoke cigarettes and smoking causes more than 15 percent of deaths among men and 7 percent among women globally. While smoking prevalence is decreasing in the developed world, it is on the rise in many developing countries. Obesity due to both unhealthy foods and physical inactivity is also increasing in the developing world, especially in the Middle East, the Pacific Islands, and Latin America and the Caribbean where many countries are experiencing obesity rates above 20 percent for males and more than 40 percent for females.Engaging in such risky behaviors, according to the report, exerts a significant toll on the individual’s productivity in the long-run. Society suffers as immediate peers of those who engage in risky behaviors may also experience declines in their productivity. Children are at particular risk, for example if they have to stop schooling due to a sick parent or if development of their cognitive abilities is compromised due to early exposure to harmful substances. Furthermore, in most low-income countries, it is difficult to formally insure against these costly consequences, given the rarity of both health insurance and public or private disability benefits. According to the World Bank’s World Development Indicators, 75 percent of private expenditure on health was financed through out-of-pocket payments in low-income countries in 2011. “Individuals’ risky behaviors that cluster amongst the poor ripple throughout entire populations, crippling families’ potential and undermining the great health and economic progress we’ve seen in low- and middle-income countries in recent years,” said Tim Evans, Director of Health, Nutrition and Population at the World Bank Group. “Reversing the tide of these pernicious behaviors by promoting societal conditions for better health choices will pay dividends for families and countries across the globe, ultimately helping us end extreme poverty and promote inclusive and healthy growth.”The report concludes that the costs and spillovers associated with risky behaviors justify public interventions and that certain policies, when done properly, can improve overall welfare. Evidence suggests that legislation tends to be effective, especially when enforcement mechanisms are strong. Tax policies can be efficient mechanisms to prevent smoking and alcohol consumption. Most of the evidence comes from developed countries, but emerging evidence from developing countries –such as from China and Indonesia for tobacco taxes and from Kenya for alcohol prices— points in the same direction. Show Less -
WASHINGTON, October 31, 2013 – The World Bank’s Board of Executive Directors has approved US$10 million today to help Kenya prepare to expand the Cash Transfer for Orphans and Vulnerable Children Proj... Show More +ect, an initiative that is already supporting 153,000 selected Kenyan households through regular cash transfers.Monthly payments through the program have helped households to send orphans and vulnerable children to school and provide them with basic nutrition and health care. There is strong evidence that the program, which is financed by the Kenyan government and a multi-donor trust fund managed by the World Bank, has helped reduce child labor on farms and the vulnerability of adolescents in these households to HIV infection. The new IDA* credit will help the Kenyan government to systematically include more households as part of this effort, sustain its good results, and draw lessons from its success that can be applied to other cash transfer programs under the country’s overarching National Safety Net Program. The funds will also be used to help Kenya to move towards electronic payments to safety net beneficiaries, and to develop an effective mechanism to handle complaints.“It is very encouraging that regular cash transfers to households with orphans and vulnerable children are helping to protect these children from the worst effects of extreme poverty,” said Diarietou Gaye, World Bank Country Director for Kenya. “This effort is now a part of a comprehensive national safety net program which we hope will help to reduce poverty in Kenya—still very high at 38 percent—and to build resilience on a large scale.” The World Bank-supported National Safety Nets Program includes five initiatives: the Cash Transfer for Orphans and Vulnerable Children, the Hunger Safety Net Program, the Older Persons Cash Transfer, the Urban Food Subsidy Cash Transfer, and the Persons with Severe Disability Cash Transfer.“In helping Kenya to reach the poorest and most vulnerable people in the country, we are deliberately focusing on results, and this new funding will help the whole national safety net system to function more effectively,” said Cornelia Tesliuc, Senior Social Protection Specialist at the World Bank and task team leader for the project.* The World Bank’s International Development Association (IDA), established in 1960, helps the world’s poorest countries by providing zero-interest loans and grants for projects and programs that boost economic growth, reduce poverty, and improve poor people’s lives. IDA is one of the largest sources of assistance for the world’s 82 poorest countries, 40 of which are in Africa. Resources from IDA bring positive change for 2.5 billion people living on less than $2 a day. Since 1960, IDA has supported development work in 108 countries. Annual commitments have increased steadily and averaged about $16 billion over the last three years, with about 50 percent of commitments going to Africa Show Less -