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DCP2 is a comprehensive, 1440-page resource that provides an updated "checkup" for global health and health care. As part of the "health examination," DCP2 asked: What progress has been made in defining and reducing the global burden of disease? How much have countries accomplished in developing and providing efficient, effective, and equitable health care? How can they set and achieve priorities in health services? Once these countries have identified the priorities, how can they deliver interventions to the targeted population in the most cost-effective manner? How can the efforts of the health and closely related sectors (such as nutrition, agriculture, water and sanitation, and education) be integrated to optimize health improvements?
DCP2's answers contribute substantially to global initiatives to improve the health of all peoples by providing a multidisciplinary understanding of these fundamental issues and challenges, as well as effective interventions for the range of communicable and noncommunicable diseases and conditions and risk factors.
Underlying all medical and economic analyses is the appreciation of the need to strengthen health systems so that they can provide highly cost-effective interventions on a large scale. Applying the information, analysis, and strategies set out in DCP2 requires a careful assessment of the local situation, including patterns of disease, institutional capacity, and resources. Combining insights from DCP2 and knowledge of their local situation, actors at many levels—from parliamentarians and health ministers to hospital administrators, health care workers, and concerned citizens—will be able to set priorities, select appropriate interventions, devise better means of delivery, improve management, and be more effective in mobilizing resources. In this manner, the benefits of technical progress in improving health can be extended and shared by all.
Contents
- Dedication
- Foreword
- Preface
- Editors
- Advisory Committee to the Editors
- Contributors
- Acknowledgments
- Disease Control Priorities Project Partners
- Abbreviations and Acronyms
- Summary and Cross-Cutting Themes
- Chapter 1. Investing in HealthDean T. Jamison.
- The 20th Century Takeoff in Human Health
- The Economic Benefits of Better Health
- Why Has Mortality Declined at Such Different Rates in Different Countries?
- Child Health
- HIV/AIDS
- Noncommunicable Disease and Injury
- Health System Development and Finance
- Research and Development
- Development Assistance for Health
- Conclusions
- Annex 1.A: The Burden of Disease in 2001
- Acknowledgements
- References
- Chapter 2. Intervention Cost-Effectiveness: Overview of Main MessagesRamanan Laxminarayan, Jeffrey Chow, and Sonbol A. Shahid-Salles.
- Chapter 3. Strengthening Health SystemsAnne Mills, Fawzia Rasheed, and Stephen Tollman.
- Chapter 4. Priorities for Global Research and Development of InterventionsBarry R. Bloom, Catherine M. Michaud, John R. La Montagne, and Lone Simonsen.
- Chapter 5. Science and Technology for Disease Control: Past, Present, and FutureDavid Weatherall, Brian Greenwood, Heng Leng Chee, and Prawase Wasi.
- Chapter 6. Product Development PrioritiesAdel Mahmoud, Patricia M. Danzon, John H. Barton, and Roy D. Mugerwa.
- Chapter 7. Economic Approaches to Valuing Global Health ResearchDavid Meltzer.
- Chapter 8. Improving the Health of Populations: Lessons of ExperienceCarol Ann Medlin, Mushtaque Chowdhury, Dean T. Jamison, and Anthony Measham.
- Chapter 9. Millennium Development Goals for Health: What Will It Take to Accelerate
Progress?Adam Wagstaff, Mariam Claeson, Robert M. Hecht, Pablo Gottret, and Qiu Fang.
- Chapter 10. Gender Differentials in HealthMayra Buvinić, André Medici, Elisa Fernández, and Ana Cristina Torres.
- Chapter 11. Fiscal Policies for Health Promotion and Disease PreventionRachel Nugent and Felicia Knaul.
- Chapter 12. Financing Health Systems in the 21st CenturyGeorge Schieber, Cristian Baeza, Daniel Kress, and Margaret Maier.
- Chapter 13. Recent Trends and Innovations in Development Assistance for
HealthRobert Hecht and Raj Shah.
- Chapter 14. Ethical Issues in Resource Allocation, Research, and New Product
DevelopmentDan W. Brock and Daniel Wikler.
- Chapter 15. Cost-Effectiveness Analysis for Priority
SettingPhilip Musgrove and Julia Fox-Rushby.
- Cost-Effectiveness and Priority Setting
- Definition and Characteristics of Interventions
- Estimating Effectiveness in Health
- Determining Costs for Interventions
- More and Less Comprehensive Data and Analysis
- Cost-Effectiveness and Population Impact
- Improvements and Further Applications
- Acknowledgments
- References
- Chapter 1. Investing in Health
- Selecting Interventions
- Chapter 16. TuberculosisChristopher Dye and Katherine Floyd.
- Tuberculosis Infection, Disease, and Death
- Epidemiological Burden and Trends
- Interventions against Tuberculosis
- Alternative and Complementary Approaches to the Diagnosis and Treatment of Active Disease
- Cost-Effectiveness of Interventions against Tuberculosis
- Cost-Effectiveness of Managing Endemic Tuberculosis
- Cost-Effectiveness of Managing Tuberculosis Outbreaks
- Summary of Cost-Effectiveness Analyses
- Research and Development
- Conclusions
- Acknowledgments
- References
- Chapter 17. Sexually Transmitted InfectionsSevgi O. Aral, Mead Over, Lisa Manhart, and King K. Holmes.
- Chapter 18. HIV/AIDS Prevention and TreatmentStefano Bertozzi, Nancy S. Padian, Jeny Wegbreit, Lisa M. DeMaria, Becca Feldman, Helene Gayle, Julian Gold, Robert Grant, and Michael T. Isbell.
- Chapter 19. Diarrheal DiseasesGerald T. Keusch, Olivier Fontaine, Alok Bhargava, Cynthia Boschi-Pinto, Zulfiqar A. Bhutta, Eduardo Gotuzzo, Juan Rivera, Jeffrey Chow, Sonbol Shahid-Salles, and Ramanan Laxminarayan.
- Chapter 20. Vaccine-preventable DiseasesLogan Brenzel, Lara J. Wolfson, Julia Fox-Rushby, Mark Miller, and Neal A. Halsey.
- Causes and Epidemiology of Diseases Prevented by Vaccines Used in National Immunization Programs
- Estimates of the Current Burden of Vaccine-preventable Diseases and of the Burden Averted by Vaccination
- Expanded Program on Immunization
- Costs and Cost-Effectiveness of Existing Vaccination Programs
- Cost-Effectiveness of Increasing Immunization Coverage for the Traditional EPI
- Costs and Cost-Effectiveness of Adding New Antigens to the Current Immunization Schedule
- Financial Sustainability of Immunization Programs
- Improving the Costs and Cost-Effectiveness of Immunization Programs
- Research Agenda
- Conclusions
- Acknowledgments
- References
- Chapter 21. Conquering
MalariaJoel G. Breman, Anne Mills, Robert W. Snow, Jo-Ann Mulligan, Christian Lengeler, Kamini Mendis, Brian Sharp, Chantal Morel, Paola Marchesini, Nicholas J. White, Richard W. Steketee, and Ogobara K. Doumbo.
- Chapter 22. Tropical Diseases Targeted for Elimination: Chagas Disease, Lymphatic Filariasis, Onchocerciasis, and LeprosyJan H. F. Remme, Piet Feenstra, P. R. Lever, Andre C. Medici, Chantal M. Morel, Mounkaila Noma, K. D. Ramaiah, Frank Richards, A. Seketeli, Gabriel Schmunis, W. H. van Brakel, and Anna Vassall.
- Chapter 23. Tropical Diseases Lacking Adequate Control Measures: Dengue, Leishmaniasis, and African TrypanosomiasisP. Cattand, P. Desjeux, M. G. Guzmán, J. Jannin, A. Kroeger, A. Medici, P. Musgrove, M. B. Nathan, A. Shaw, and C. J. Schofield.
- Chapter 24. Helminth Infections: Soil-transmitted Helminth Infections and SchistosomiasisPeter J. Hotez, Donald A. P. Bundy, Kathleen Beegle, Simon Brooker, Lesley Drake, Nilanthi de Silva, Antonio Montresor, Dirk Engels, Matthew Jukes, Lester Chitsulo, Jeffrey Chow, Ramanan Laxminarayan, Catherine Michaud, Jeff Bethony, Rodrigo Correa-Oliveira, Xiao Shuhua, Alan Fenwick, and Lorenzo Savioli.
- Causes and Characteristics of Helminth Infections
- Epidemiology of STH Infections and Schistosomiasis
- Burden of the Disease
- Cost-Effectiveness Analysis of Interventions
- Averted, Avertable, and Nonavertable Burden
- Economic Benefits of Intervention
- Implementation of Control Strategies: Lessons of Experience
- Research and Development
- Conclusions: Promises and Pitfalls
- References
- Chapter 25. Acute Respiratory Infections in ChildrenEric A. F. Simoes, Thomas Cherian, Jeffrey Chow, Sonbol A. Shahid-Salles, Ramanan Laxminarayan, and T. Jacob John.
- Chapter 26. Maternal and Perinatal ConditionsWendy J. Graham, John Cairns, Sohinee Bhattacharya, Colin H. W. Bullough, Zahidul Quayyum, and Khama Rogo.
- Chapter 27. Newborn SurvivalJoy E. Lawn, Jelka Zupan, Geneviève Begkoyian, and Rudolf Knippenberg.
- Chapter 28. Stunting, Wasting, and Micronutrient Deficiency DisordersLaura E. Caulfield, Stephanie A. Richard, Juan A. Rivera, Philip Musgrove, and Robert E. Black.
- Chapter 29. Health Service Interventions for Cancer Control in Developing CountriesMartin L. Brown, Sue J. Goldie, Gerrit Draisma, Joe Harford, and Joseph Lipscomb.
- Chapter 30. Diabetes: The Pandemic and Potential
SolutionsK. M. Venkat Narayan, Ping Zhang, Alka M. Kanaya, Desmond E. Williams, Michael M. Engelgau, Giuseppina Imperatore, and Ambady Ramachandran.
- Chapter 31. Mental
DisordersSteven Hyman, Dan Chisholm, Ronald Kessler, Vikram Patel, and Harvey Whiteford.
- Chapter 32. Neurological DisordersVijay Chandra, Rajesh Pandav, Ramanan Laxminarayan, Caroline Tanner, Bala Manyam, Sadanand Rajkumar, Donald Silberberg, Carol Brayne, Jeffrey Chow, Susan Herman, Fleur Hourihan, Scott Kasner, Luis Morillo, Adesola Ogunniyi, William Theodore, and Zhen-Xin Zhang.
- Chapter 33. Cardiovascular DiseaseThomas Gaziano, K. Srinath Reddy, Fred Paccaud, Sue Horton, and Vivek Chaturvedi.
- Chapter 34. Inherited Disorders of HemoglobinDavid Weatherall, Olu Akinyanju, Suthat Fucharoen, Nancy Olivieri, and Philip Musgrove.
- Chapter 35. Respiratory Diseases of AdultsFrank E. Speizer, Susan Horton, Jane Batt, and Arthur S. Slutsky.
- Chapter 36. Diseases of the Kidney and the Urinary
SystemJohn Dirks, Giuseppe Remuzzi, Susan Horton, Arrigo Schieppati, and S. Adibul Hasan Rizvi.
- Causes and Characteristics of the Burden of Diseases
- Causes of Diseases of the Kidney and Urinary System
- Global Perspectives in Relation to RRT
- Economic Benefits of Intervention
- Implementation of Control Strategies: Lessons of Experience
- Research and Development Agenda
- Conclusions: Promises and Pitfalls
- References
- Chapter 37. Skin DiseasesRoderick Hay, Sandra E. Bendeck, Suephy Chen, Roberto Estrada, Anne Haddix, Tonya McLeod, and Antone Mahé.
- Chapter 38. Oral and Craniofacial Diseases and DisordersDouglas Bratthall, Poul Erik Petersen, Jayanthi Ramanathan Stjernswärd, and L. Jackson Brown.
- Dental Caries
- Aspects of Treatment of Cavities and of Caries Disease
- Periodontal Diseases: Chronic Gingivitis and Chronic Periodontitis
- Oral Precancer and Cancer
- Oral Manifestations of HIV/AIDS
- Noma (Cancrum oris)
- Developmental Disorders
- Fluorosis of Teeth
- Common-Risk-Factor Intervention Programs
- Research and Future Actions
- Cost-Effectiveness of Oral Health Care
- Conclusions
- Acknowledgments
- References
- Chapter 39. Unintentional InjuriesRobyn Norton, Adnan A. Hyder, David Bishai, and Margie Peden.
- Chapter 40. Interpersonal ViolenceMark L. Rosenberg, Alexander Butchart, James Mercy, Vasant Narasimhan, Hugh Waters, and Maureen S. Marshall.
- Chapter 41. Water Supply, Sanitation, and Hygiene PromotionSandy Cairncross and Vivian Valdmanis.
- Chapter 42. Indoor Air PollutionNigel Bruce, Eva Rehfuess, Sumi Mehta, Guy Hutton, and Kirk Smith.
- Chapter 43. Air and Water Pollution: Burden and Strategies for ControlTord Kjellstrom, Madhumita Lodh, Tony McMichael, Geetha Ranmuthugala, Rupendra Shrestha, and Sally Kingsland.
- Chapter 44. Prevention of Chronic Disease by Means of Diet and Lifestyle
ChangesWalter C. Willett, Jeffrey P. Koplan, Rachel Nugent, Courtenay Dusenbury, Pekka Puska, and Thomas A. Gaziano.
- Chapter 45. The Growing Burden of Risk from High Blood Pressure, Cholesterol, and BodyweightAnthony Rodgers, Carlene M. M. Lawes, Thomas Gaziano, and Theo Vos.
- Chapter 46. Tobacco
AddictionPrabhat Jha, Frank J. Chaloupka, James Moore, Vendhan Gajalakshmi, Prakash C. Gupta, Richard Peck, Samira Asma, and Witold Zatonski.
- Smoking Trends
- Health Consequences of Smoking
- Rationale for Government Intervention
- Interventions to Reduce Demand for Tobacco
- Interventions to Reduce the Supply of Tobacco
- Effectiveness and Cost-Effectiveness of Tobacco-Control Interventions
- Comprehensive Tobacco-Control Programs
- Constraints to Effective Tobacco-Control Policies
- Conclusion
- Acknowledgements
- References
- Chapter 47. AlcoholJürgen Rehm, Dan Chisholm, Robin Room, and Alan D. Lopez.
- Epidemiology of Alcohol Use and Alcohol-related Disease Conditions
- Burden of Disease Related to High-Risk Alcohol Use
- Interventions for Reducing High-Risk Drinking
- Cost-Effectiveness of Interventions
- Economic Benefits of Interventions
- Implementation of Control Strategies: Lessons of Experience
- Research and Development Agenda
- Conclusion
- References
- Chapter 48. Illicit Opiate
AbuseWayne Hall, Chris Doran, Louisa Degenhardt, and Donald Shepard.
- Nature, Causes, and Health Consequences of Illicit Opioid Use
- Contribution of Opioid Dependence to the Global Burden of Disease
- Interventions for Illicit Opioid Dependence
- Relevance to Developing Countries
- Research and Development
- Conclusions: Promises and Pitfalls
- Annex 48.A: Prevalence of Use, Adverse Health Effects of and Interventions for Cannabis, Cocaine, Amphetamines, and MDMA Use and Dependence
- References
- Chapter 49. Learning and Developmental DisabilitiesMaureen S. Durkin, Helen Schneider, Vikram S. Pathania, Karin B. Nelson, Geoffrey C. Solarsh, Nicole Bellows, Richard M. Scheffler, and Karen J. Hofman.
- LDD and the Global Burden of Disease
- Impairment, Disability, and Participation
- Three Levels of Prevention
- Unintended Consequences of Successful or Partially Successful Interventions
- Other Factors Leading to Increases in Measured Prevalence
- Interventions in Low- and Middle-Income Countries
- Research Agenda for Prevention of Disabilities in Low- and Middle-Income Countries
- Summary
- Acknowledgments
- References
- Chapter 50. Loss of Vision and HearingJoseph Cook, Kevin D. Frick, Rob Baltussen, Serge Resnikoff, Andrew Smith, Jeffrey Mecaskey, and Peter Kilima.
- Chapter 51. Cost-Effectiveness of Interventions for Musculoskeletal
ConditionsLuke B. Connelly, Anthony Woolf, and Peter Brooks.
- Burden of Musculoskeletal Disease
- Nature, Causes, and Epidemiology of Musculoskeletal Conditions
- Preventive Strategies
- Treatments
- Economic Issues
- Cost-Effectiveness of Interventions for OA
- Cost-Effectiveness of Interventions for RA
- Cost-Effectiveness of Interventions for Other Musculoskeletal Conditions
- Implementation of Control Strategies: Lessons of Experience
- Research and Development
- Conclusions: Promises and Pitfalls
- Acknowledgments
- References
- Chapter 52. Pain Control for People with Cancer and AIDSKathleen M. Foley, Judith L. Wagner, David E. Joranson, and Hellen Gelband.
- Chapter 16. Tuberculosis
- Strengthening Health Systems
- Chapter 53. Public Health Surveillance: A Tool for Targeting and Monitoring InterventionsPeter Nsubuga, Mark E. White, Stephen B. Thacker, Mark A. Anderson, Stephen B. Blount, Claire V. Broome, Tom M. Chiller, Victoria Espitia, Rubina Imtiaz, Dan Sosin, Donna F. Stroup, Robert V. Tauxe, Maya Vijayaraghavan, and Murray Trostle.
- Definitions and Basic Concepts
- Objectives of Surveillance Systems
- Principles and Uses of Surveillance
- Establishing and Maintaining a Surveillance System
- Analysis and Dissemination of Surveillance Data
- Surveillance as a Component of National Public Health Systems
- Surveillance as a Tool to Improve Public Health
- Selected Surveillance Strategies
- The Role of Surveillance in Major Outbreaks
- Surveillance for Specific Conditions
- Economics of Public Health Surveillance Systems
- Future of Surveillance
- Global Surveillance Networks
- Research Agenda in Public Health Surveillance
- Conclusion
- Acknowledgments
- References
- Chapter 54. Information to Improve Decision Making for HealthSally K. Stansfield, Julia Walsh, Ndola Prata, and Timothy Evans.
- Chapter 55. Drug ResistanceRamanan Laxminarayan, Zulfiqar Bhutta, Adrian Duse, Philip Jenkins, Thomas O'Brien, Iruka N. Okeke, Ariel Pablo-Mendez, and Keith P. Klugman.
- Chapter 56. Community Health and Nutrition ProgramsJohn B. Mason, David Sanders, Philip Musgrove, Soekirman, and Rae Galloway.
- Chapter 57. ContraceptionRuth Levine, Ana Langer, Nancy Birdsall, Gaverick Matheny, Merrick Wright, and Angela Bayer.
- Chapter 58. School-based Health and Nutrition ProgramsDonald Bundy, Sheldon Shaeffer, Matthew Jukes, Kathleen Beegle, Amaya Gillespie, Lesley Drake, Seung-hee Frances Lee, Anna-Maria Hoffman, Jack Jones, Arlene Mitchell, Delia Barcelona, Balla Camara, Chuck Golmar, Lorenzo Savioli, Malick Sembene, Tsutomu Takeuchi, and Cream Wright.
- Infectious Disease and School-Age Children
- Malnutrition, Noninfectious Disease, and Health and Education
- Estimating the Burden of Disease
- Interventions
- Cost-Effectiveness of Intervention
- Economic Benefits of Intervention
- Implementation of Programs and Lessons from Experience
- Research and Development Agenda
- Conclusions
- References
- Chapter 59. Adolescent Health ProgramsElizabeth Lule, James E. Rosen, Susheela Singh, James C. Knowles, and Jere R. Behrman.
- Chapter 60. Occupational
HealthLinda Rosenstock, Mark Cullen, and Marilyn Fingerhut.
- Chapter 61. Natural Disaster Mitigation and ReliefClaude de Ville de Goyet, Ricardo Zapata Marti, and Claudio Osorio.
- Chapter 62. Control and EradicationMark Miller, Scott Barrett, and D. A. Henderson.
- Chapter 63. Integrated Management of the Sick
ChildCesar G. Victora, Taghreed Adam, Jennifer Bryce, and David B. Evans.
- Chapter 64. General Primary CareStephen Tollman, Jane Doherty, and Jo-Ann Mulligan.
- Chapter 65. The District
HospitalMike English, Claudio F. Lanata, Isaac Ngugi, and Peter C. Smith.
- Chapter 66. Referral HospitalsMartin Hensher, Max Price, and Sarah Adomakoh.
- Chapter 67. SurgeryHaile T. Debas, Richard Gosselin, Colin McCord, and Amardeep Thind.
- Chapter 68. Emergency Medical ServicesOlive C. Kobusingye, Adnan A. Hyder, David Bishai, Manjul Joshipura, Eduardo Romero Hicks, and Charles Mock.
- Chapter 69. Complementary and Alternative MedicineHaile T. Debas, Ramanan Laxminarayan, and Stephen E. Straus.
- Definitions and Domains of Complementary and Alternative Medicine and Traditional Medicine
- Demography, Use, Toxicity, and Efficacy
- Economics of Complementary and Alternative Medicine and Traditional Medicine
- Expanding the Beneficial Use of Complementary and Alternative Medicine and Traditional Medicine
- Lessons Learned and Implementation
- The Research and Development Agenda
- References
- Chapter 70. Improving the Quality of Care in Developing CountriesJohn W. Peabody, Mario M. Taguiwalo, David A. Robalino, and Julio Frenk.
- Chapter 71. Health Workers: Building and Motivating the WorkforceCharles Hongoro and Charles Normand.
- Chapter 72. Ensuring Supplies of Appropriate Drugs and
VaccinesSusan Foster, Richard Laing, Bjørn Melgaard, and Michel Zaffran.
- Drug Policies
- Vaccine Policies
- Selection of Drugs
- Selection of Vaccines
- Procurement of Drugs
- Procurement of Vaccines
- Quality Assurance for Pharmaceuticals and Vaccines
- The WHO Prequalification Schemes
- Local Production of Pharmaceuticals
- Storage and Distribution of Essential Drugs and Vaccines
- Prescription and Rational Use of Drugs
- Dispensing
- Adherence
- Financing Issues
- Sustainable Financing of Vaccines and Immunizations
- Issues for the Future
- Vaccine Research Priorities
- Priorities for Pharmaceutical Research
- Conclusion
- References
- Chapter 73. Strategic Management of Clinical ServicesAlexander S. Preker, Martin McKee, Andrew Mitchell, and Suwit Wilbulpolprasert.
- Chapter 53. Public Health Surveillance: A Tool for Targeting and Monitoring Interventions
- Glossary
This volume was funded in part by a grant from the Bill & Melinda Gates Foundation and is a product of the staff of the International Bank for Reconstruction and Development / the World Bank, the World Health Organization, and the Fogarty International Center of the National Institutes of Health.
The findings, interpretations, and conclusions expressed in this volume do not necessarily reflect the views of the executive directors of the World Bank or the governments they represent, the World Health Organization, or the Fogarty International Center of the National Institutes of Health.
The World Bank, the World Health Organization, and the Fogarty International Center of the National Institutes of Health do not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgement on the part of the World Bank, the World Health Organization, or the Fogarty International Center of the National Institutes of Health concerning the legal status of any territory or the endorsement or acceptance of such boundaries.
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