Latin American And The Caribbean Research Articles

How international organizations can support the development of cardio-oncology in the Latin American and the Caribbean region

Abstract Health problems in the Latin American and the Caribbean (LAC) region are highly concentrated on non-communicable diseases, being cardiovascular diseases (CVDs) and cancer the leading causes of death. Different countries of the region are at different stages of development in addressing CVDs and cancer. Opportunities for training and continuing education in cardio-oncology, as well as active cardio-oncology groups, are primarily limited to large academic institutions in major metropolitan areas. In addition, the development of advanced imaging modalities in LAC faces challenges such as the high cost of equipment, a lack of equipment maintenance and service, as well as insufficient specific training for both imaging specialists and referring clinicians. To contribute to the implementation of actionable strategies ensuring equitable access to care for all, international organizations, such as the International Atomic Energy Agency (IAEA), offer support for the regional development of health projects that address educational needs. In this context, a new IAEA regional cooperation project for LAC titled ‘Strengthening of regional capacities on the use of Nuclear Medicine techniques in a Cardio-oncology multimodality approach in patients with cancer’ will be developed during 2024–2025. The experience of some centres, as well as national experiences in certain countries of the region, that have been previously involved in other regional projects, can be leveraged for the benefit of the entire region. We present a proposed road map for cross-institutional/countries collaboration in the development of cardio-oncology in the LAC region, contributing to decreasing the barriers to the growth of the subspecialty.

MiRNAs peripheral biomarkers for early diagnosis of AD in Latinamerican population

AbstractBackgroundTimely diagnosis of Alzheimer’s disease (AD) is a critical first step in clinical care treatment. However, the availability of diagnostic tools for these conditions is either unavailable or unaffordable, especially in Latin American and the Caribbean (LAC) countries. In this scenario, microRNAs (miRNA) have recently emerged as promising cost‐effective and noninvasive biomarkers since they can be readily detected in different biofluids such as plasma bound to protein or inside exosomes. Our aim is to identify new blood biomarkers to calculate the risk to develop AD in the early stages using machine learning based on exosomal miRNAs detection and different cognitive domains.MethodmiRNAs were extracted from plasma circulating exosomes samples of Subjective Cognitive Complaint subjects belonging to the GERO cohort in two different times (T1 = baseline and T2 = 18 months, n = 50). miRNAs were sequencing to identify the expression levels. Dysregulated miRNAs were analyzed and correlated with neuropsychological evaluations to create machine learning algorithms. miRNAs obtained from algorithms were validated in a new population of subjects at both stages (T1 and T2, n = 50), using qRT‐PCR and correlation analysis with neuropsychological tests.ResultFor algorithm development, we classified subjects into stationary and progressive impairment. Algorithms were trained using the sequenced miRNAs, neuropsychological tests and neuroimaging. As possible predictors of progression of cognitive impairment, the best performing algorithm was Random forest using only miRNAs data. In a new group of subjects, three miRNAs selected by the algorithm and four miRNAs obtained from the literature were validated and the ROC curves were constructed. The combination of these miRNAs (algorithm and literature miRNAs), were the best predictor of the progression of cognitive impairment.ConclusionThis study could be used in the initial phases of the diagnostic process of AD because it is minimally invasive, low cost and accessible to a large number of patients in Latin American and the Caribbean (LAC) countries.

Recent trends in maternal and child health inequalities in Latin America and the Caribbean: analysis of repeated national surveys

BackgroundAlthough most Latin American and the Caribbean (LAC) countries made important progress in maternal and child health indicators from the 1990s up to 2010, little is known about such progress in the last decade. This study aims at documenting progress for each country as a whole, and to assess how within-country socioeconomic inequalities are evolving over time.MethodsWe identified LAC countries for which a national survey was available between 2011–2015 and a second comparable survey in 2018–2020. These included Argentina, Costa Rica, Cuba, the Dominican Republic, Guyana, Honduras, Peru, and Suriname. The 16 surveys included in the analysis collected nationally representative data on 221,989 women and 152,983 children using multistage sampling. Twelve health-related outcomes were studied, seven of which related to intervention coverage: the composite coverage index, demand for family planning satisfied with modern methods, antenatal care (four or more visits and eight or more visits), skilled attendant at birth, postnatal care for the mother and full immunization coverage. Five additional impact indicators were also investigated: stunting prevalence among under-five children, tobacco use by women, adolescent fertility rate, and under-five and neonatal mortality rates. For each of these indicators, average annual relative change rates were calculated between the baseline and endline national level estimates, and changes in socioeconomic inequalities over time were assessed using the slope index of inequality.ResultsProgress over time and the magnitude of inequalities varied according to country and indicator. For countries and indicators where baseline levels were high, as Argentina, Costa Rica and Cuba, progress was slow and inequalities small for most indicators. Countries that still have room for improvements, such as Guyana, Honduras, Peru and Suriname, showed faster progress for some but not all indicators, although also had wider inequalities. Among the countries studied, Peru was the top performer in terms of increasing coverage and reducing inequalities over time, followed by Honduras. Declines in family planning and immunization coverage were observed in some countries, and the widest inequalities were present for adolescent fertility and antenatal care coverage with eight or more visits.ConclusionsAlthough LAC countries are well placed in terms of current levels of health indicators compared to most low- and middle-income countries, important inequalities remain, and reversals are being observed in some areas. More targeted efforts and actions are needed in order to leave no one behind. Monitoring progress with an equity lens is essential, but this will require further investment in conducting surveys routinely.

Status and opportunities for improvement in greenhouse gas emission inventories for the cattle production in Latin America and the Caribbean region: A perspective

The Intergovernmental Panel on Climate Change (IPCC) provides the reference for national greenhouse gas emission (GHG) inventories towards standardized, accurate, measurable, and comparable National Inventory Reports (NIR). For compliance with the 1.5⁰C commitments under the Paris Agreement, most countries have made efforts to improve their inventory methods to tier 2 or 3. However, some relevant activities within Latin American and the Caribbean (LAC) countries, such as enteric methane emissions and methane and nitrous oxide emissions from cattle manure management are still estimated using tier 1 methods, which leads to a high uncertainty due to the importance of livestock emissions in the national totals for these countries. In this context, reducing the uncertainty in GHG inventories would not only improve the accuracy of national reports but it would also provide solid baselines for national mitigation initiatives e.g., Nationally Determined Contributions under the Paris Agreement, and accurate tools to venture into carbon bonds or payments for ecosystem services. The aim of this study was to review the status of national GHG inventories specifically for these three cattle emission categories in 11 LAC countries. We conducted a survey of GHG inventory experts in the 11 LAC countries, to identify the potential for improvement and the main barriers to achieving this. Despite some initiatives, there is still a large potential for reducing the uncertainty in LAC national GHG emission estimates, the barriers to or solutions can be categorized as technical, policy, and institutional issues. However, improving the GHG inventories of LAC countries, specifically for cattle emissions, is feasible in the medium term, as long as multilateral actions are considered, coherently linked under a comparable and verifiable methodology and including a commitment by countries to invest public funds in relevant research and innovations.

An updated examination of the perception of barriers for pharmacogenomics implementation and the usefulness of drug/gene pairs in Latin America and the Caribbean.

Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers based on their importance. In addition, a paired list of 54 genes/drugs was analyzed to determine an association between biomarkers and response to genomic medicine. This survey was compared to a previous survey performed in 2014 to assess progress in the region. The search results indicated that Latin American and Caribbean countries have contributed 3.44% of the total publications and 2.45% of the PGx-related clinical trials worldwide thus far. A total of 106 professionals from 17 countries answered the survey. Six major groups of barriers were identified. Despite the region's continuous efforts in the last decade, the primary barrier to PGx implementation in LAC remains the same, the "need for guidelines, processes, and protocols for the clinical application of pharmacogenetics/pharmacogenomics". Cost-effectiveness issues are considered critical factors in the region. Items related to the reluctance of clinicians are currently less relevant. Based on the survey results, the highest ranked (96%-99%) gene/drug pairs perceived as important were CYP2D6/tamoxifen, CYP3A5/tacrolimus, CYP2D6/opioids, DPYD/fluoropyrimidines, TMPT/thiopurines, CYP2D6/tricyclic antidepressants, CYP2C19/tricyclic antidepressants, NUDT15/thiopurines, CYP2B6/efavirenz, and CYP2C19/clopidogrel. In conclusion, although the global contribution of LAC countries remains low in the PGx field, a relevant improvement has been observed in the region. The perception of the usefulness of PGx tests in biomedical community has drastically changed, raising awareness among physicians, which suggests a promising future in the clinical applications of PGx in LAC.

Views of government and non-government actors on urban forest management and governance in ten Latin-American capital cities

Addressing urban forest management and governance challenges is fundamental for implementing urban forest policies. Most of the evidence on this topic comes from Global North cities, so little is known about how urban forest management and governance are experienced by urban forest actors in Global South cities, including Latin American and the Caribbean (LAC) cities. This study aimed to assess the views of urban forest actors in LAC cities on how they participate in collective decision-making, the current state of urban forest management and governance, and contact among actors, with a focus on how these views related to each other and differences among government and non-government actors. We designed and delivered an online survey to government and non-government actors in ten LAC capital cities, including Bogotá, Brasília, Buenos Aires, Ciudad de México, Ciudad de Panamá, La Paz, Lima, San José , San Juan, and Santiago de Chile. We analysed 155 responses using regression-based techniques. We found that more contact among actors resulted in more participation in collective decision making and more optimistic views about the state of urban forest management and governance. Also, more optimistic views about the state of urban forest management and governance resulted in more trust in local governments. Non-government actors had lower levels of trust in local governments than government actors. We discuss how implementing urban forest policies does not solely depend on having enough resources (e.g., finances, personnel) but also on engaging in collective decision-making and improving trust in the institutions in charge of implementing urban forest policies.

Econometric analysis of the determinants of air cargo services supply in Latin America and the Caribbean

This paper examines econometrically the determinants of air cargo supply in the countries of Latin American and the Caribbean (LAC) using city-pair data for 2011–2020. We find that air cargo supply tends to be concentrated in airports located in highly populated cities. The relationship between income and air cargo supply is more complex although its positive effect seems to be more consistent for dedicated cargo flights. In addition, we only find a negative relationship between distance and air cargo supply when we focus on belly cargo. Low-cost airlines spur cargo in passenger flights buy they do not have any positive role in dedicated cargo flights. Free trade agreements seem to contribute positively to a greater supply of air cargo, but this effect is concentrated on belly cargo and intra-regional routes. In contrast, the quality of the infrastructure at the airport of origin positively impacts air cargo supply only on dedicated flights and extra-regional routes. Finally, we do find evidence that a more intense competition between airlines and the greater use of wide-body aircraft have a positive effect on cargo supply.

Health Effects of Pesticide Exposure in Latin American and the Caribbean Populations: A Scoping Review.

Background:Multiple epidemiological studies have shown that exposure to pesticides is associated with adverse health outcomes. However, the literature on pesticide-related health effects in the Latin American and the Caribbean (LAC) region, an area of intensive agricultural and residential pesticide use, is sparse. We conducted a scoping review to describe the current state of research on the health effects of pesticide exposure in LAC populations with the goal of identifying knowledge gaps and research capacity building needs.Methods:We searched PubMed and SciELO for epidemiological studies on pesticide exposure and human health in LAC populations published between January 2007 and December 2021. We identified 233 publications from 16 countries that met our inclusion criteria and grouped them by health outcome (genotoxicity, neurobehavioral outcomes, placental outcomes and teratogenicity, cancer, thyroid function, reproductive outcomes, birth outcomes and child growth, and others).Results:Most published studies were conducted in Brazil (37%, ) and Mexico (20%, ), were cross-sectional in design (72%, ), and focused on farmworkers (45%, ) or children (21%, ). The most frequently studied health effects included genotoxicity (24%, ) and neurobehavioral outcomes (21%, ), and organophosphate (OP) pesticides were the most frequently examined (26%, ). Forty-seven percent () of the studies relied only on indirect pesticide exposure assessment methods. Exposure to OP pesticides, carbamates, or to multiple pesticide classes was consistently associated with markers of genotoxicity and adverse neurobehavioral outcomes, particularly among children and farmworkers.Discussion:Our scoping review provides some evidence that exposure to pesticides may adversely impact the health of LAC populations, but methodological limitations and inconsistencies undermine the strength of the conclusions. It is critical to increase capacity building, integrate research initiatives, and conduct more rigorous epidemiological studies in the region to address these limitations, better inform public health surveillance systems, and maximize the impact of research on public policies. https://doi.org/10.1289/EHP9934

Design and Evaluation among Young Adults of a Financial Literacy Scale Focused on Key Financial Decisions

The present study underpins the design and validation of a Financial Literacy (FL) scale in the Latin American and the Caribbean (LAC) context. Though scales are available, they do not meet contextual characteristics and seem to miss out on a focus on Key Financial Decisions (KFD). Scale design was consistent with an extensive literature review (2010–2021). Forty-four items scale covering the dimensions of Financial Attitude, Financial Behavior, and Financial Knowledge were presented to 478 young adults aged 18–30, and women 58% of them. The results reflect a robust FL scale by applying Confirmatory Factor Analysis (CFA). The data about young adults’ FL can be used as a benchmark in future studies fostering the development of FL in the Latin American and Caribbean contexts.

First Report of Fusarium oxysporum f. sp. cubense Tropical Race 4 Causing Fusarium Wilt in Cavendish Bananas in Peru.

Fusarium oxysporum f. sp. cubense Tropical Race 4 (Foc TR4), the causal agent of Fusarium wilt of banana (FWB), is currently the major threat to the banana industry worldwide (Dita et al. 2018). Restricted to South Asia for more than 20 years, Foc TR4 has spread in the last years to the Middle East, Mozambique, and Colombia (García-Bastidas et al. 2019; https://pestdisplace.org/embed/news/map/disease/11). The incursion of Foc TR4 in Colombia increased awareness and prevention efforts across Latin American and the Caribbean (LAC). However, new Foc TR4 outbreaks in LAC countries were considered a matter of time. In April 2021, banana (Musa spp., Cavendish, AAA) plants (30% of incidence) showing typical symptoms of FWB, such as leave yellowing, wilting and vascular discoloration were observed in one farm (about 1 ha) located in Querecotillo, Peru (4°43'54.84"S 80°33'45.00"W). Mycological analyses of samples (pseudostem strands) collected from 10 symptomatic plants were performed as described by Dita et al. (2010). These analyses revealed a continuous presence of fungal colonies identified as Fusarium oxysporum species complex. Molecular diagnostics targeting two different genome regions (Dita et al 2010; Li et al. 2013) identified nine of these isolates as Foc TR4. These results were further confirmed by qPCR analyses using the commercial Clear Detections TR4 kit. The genome of four single-spore isolates (PerS1, PerS2, PerS3 and PerS4) was sequenced using the Illumina platform (MiSeq Kit, 2x151 bp Paired-End). The strain PerS4 was also sequenced using Oxford Nanopore (FLOW-MIN111; R10.3 chemistry) as described by Lopez-Alvarez et al., (2020). The generated draft assembly yielded 533 contigs for a size of 47 Mbp (BioProject: PRJNA755905), which is comparable with sizes of previously reported Foc TR4 strains (Asai et al. 2019; García-Bastidas et al. 2019; Maymon et al. 2020; Warmington et al. 2019; Zheng et al. 2018). The sequence assembly showed high contiguity (94.9%) and high similarity (95.48%) with the high-quality genome sequence of the Foc TR4 isolate 'UK0001' (Warmington et al. 2019). Further analyses to identify the presence/absence of full sequences for the putative effector genes (Secreted In Xylem - SIX) and their allelic copies, also revealed that the SIX genes profile of the strains isolated from Querecotillo matched with previously reported Foc TR4 isolates (Czislowski et al. 2017). Pathogenicity tests with three isolates and water controls were performed as described by Dita et al. (2010), using five Cavendish plantlets per treatment. Four weeks after the inoculation typical external and internal symptoms of FWB were observed only in the inoculated plants. Fungal isolates recovered from inoculated plants tested positive for Foc TR4 when analyzed with PCR diagnostics as mentioned above. No fungal isolates were recovered from water-control plants which did not show any symptoms. Altogether, our results confirm the first incursion of Foc TR4 in Peru. Currently, Foc TR4 has the phytosanitary status of a present pest with restricted distribution in Peru and it is under official control of the National Plant Protection Organization - SENASA. Reinforced prevention and quarantine measures, disease monitoring and capacity building to detect, contain and manage eventual new outbreaks of Foc TR4 are strongly encouraged across LAC banana producing countries, especially for those bordering Peru with larger banana plantations, such as Ecuador and Brazil.

The Impact of Sustainable Bond Issuances in the Economic Growth of the Latin American and Caribbean Countries

There is beyond any doubt that Latin America is one of the most important emerging markets in the world, which has increased its importance in the last decades. In effect, the issues of green, social, and sustainability (GSS) bonds are gaining more and more importance in the Latin American and the Caribbean (LAC) financial markets. They are specifically focused on raising funding for public expenditure programs that contribute to achieving several objectives, such as climate and environmental projects, energy efficiency, pollution prevention, sustainable agriculture, fishery and forestry, etc. The main objective of this paper is to provide a literature revision of the evolution of the issuance of GSS bonds in the LAC region and to analyze the economic growth of the countries which issue this type of bond. We will apply multiple linear regression to relate the economic growth of some countries of the LAC region with the variables proposed by the IFC Emerging Market Green Bonds Report (2019). It has been shown that the economic growth of the countries in the LAC region that are issuing GSS bonds is significantly related to the Sovereign Green Issuance (Total Planned), the ratio of Private Credit/GDP, and the Rule of Law Index. However, this research has had the limitation of the scarcity of available data in the LAC markets.

Gender Differences in Depressive and Anxiety Symptoms During the First Stage of the COVID-19 Pandemic: A Cross-Sectional Study in Latin America and the Caribbean.

BackgroundPrevious studies have suggested that the pandemic impact on mental health could vary according to gender. We aimed to evaluate the gender influence in the prevalence of depressive and anxiety symptoms in Latin American and the Caribbean (LAC) countries in the first stage of the COVID-19 pandemic.MethodsWe conducted a secondary analysis employing the Facebook–COVID-19 Symptom Survey developed by the University of Maryland. We categorized gender as men, women, and non-binary. The outcomes were the presence of anxiety or depressive symptoms, measured with two adapted questions extracted from the Kessler Psychological Distress Scale (K10). We used generalized linear models from the Poisson family, considering the survey's complex sampling. We calculated crude and adjusted prevalence ratios (PR) with their 95% confidence intervals (95% CI) and explored interactions with gender using the adjusted Wald test.ResultsWe included 1,338,320 adults from LAC countries; 48.0, 50.6, and 1.4% were men, women, and non-binary participants, respectively. The overall prevalence of anxiety or depressive symptoms was 44.8 and 46.6%, respectively. We found interactions between gender and the rest of the independent variables. In the non-binary group, the association between age and anxiety symptomatology was lost after an age of 55 years. Furthermore, whereas living in a town was associated with a lower prevalence of anxiety and depression symptomatology in men and women, this did not happen among non-binary individuals. Compliance with physical distancing was associated with a lower prevalence of anxiety and depression symptomatology among women (anxiety: PRa = 0.98; 95% CI = 0.97–0.99; p < 0.001, depression: PRa = 0.96; 95% CI = 0.95–0.97; p < 0.001) and only anxiety in non-binary participants (anxiety: PRa = 0.92; 95% CI = 0.88–0.98; p = 0.005). This was not evidenced among men participants (anxiety: PRa = 0.99; 95% CI = 0.96–1.01; p = 0.199, depression: PRa = 0.98; 95% CI = 0.96–1.00; p = 0.084). In addition, compliance with handwashing was associated with a higher prevalence of anxiety symptomatology among men (PRa = 1.06; 95% CI = 1.05–1.11; p < 0.001) and women participants (PRa = 1.03; 95% CI = 1.01–1.05; p = 0.016).ConclusionApproximately 4 out of 10 participants had anxiety or depressive symptoms. Women and non-binary gender people had more symptoms of anxiety or depression. The factors associated with these symptoms varied according to gender. It is essential to evaluate gender-related strategies to improve mental health during the COVID-19 pandemic.

Prevalence and factors associated with food insecurity in Latin America and the Caribbean during the first wave of the COVID-19 pandemic

ObjectiveWe assessed the prevalence of food insecurity (FI) and its associated factors in Latin American and the Caribbean (LAC) early during the COVID-19 pandemic. MethodsWe performed secondary data analysis of a survey conducted by Facebook and the University of Maryland. We included adults surveyed from April to May 2020. FI was measured by concerns about having enough to eat during the following week. Sociodemographic, mental health, and COVID-19-related variables were collected. We performed generalized Poisson regressions models considering the complex sampling design. We estimated crude and adjusted prevalence ratios with their 95% confidence intervals. ResultsWe included 1,324,272 adults; 50.5% were female, 42.9% were under 35 years old, 78.9% lived in a city, and 18.6% had COVID-19 symptoms. The prevalence of food insecurity in LAC was 75.7% (n = 1,016,841), with Venezuela, Nicaragua, and Haiti with 90.8%, 86.7%, and 85.5%, respectively, showing the highest prevalence. Gender, area of residence, presence of COVID-19 symptoms, and fear of getting seriously ill or that a family member gets seriously ill from COVID-19 were associated with a higher prevalence of food insecurity. In contrast, increasing age was associated with a lower prevalence. ConclusionThe prevalence of food insecurity during the first stage of the COVID-19 pandemic in LAC was high and was associated with sociodemographic and COVID-19-related variables.

Multimorbidity in Latin America and the Caribbean: a systematic review and meta-analysis

ObjectiveTo estimate the pooled prevalence of multimorbidity (≥2 non-communicable diseases in the same individual) among adults of the general population of Latin American and the Caribbean (LAC).DesignSystematic review and meta-analysis.Data...

Abstract 20: Development of International Cancer Research Partnerships Through the NCI US-Latin American-Caribbean HIV/HPV-Cancer Prevention Clinical Trials Network (ULACNet)

Abstract Purpose: Persons living with HIV have elevated risks of HPV-related cervical, anogenital, and oropharyngeal cancers. Yet, research on optimization and implementation of prevention interventions (prophylactic HPV vaccination, cervical and anogenital cancer screening and triage, and precancer therapeutics) for HPV-related cancers among persons living with HIV has been limited. With a goal to expand this evidence, and building on strong academic research partnerships developed for HIV research between institutions in the US and the Latin American and the Caribbean (LAC) region, the US National Cancer Institute (NCI) initiated ULACNet, a new Cooperative Agreement clinical trials network in 2019. Methods: ULACNet comprises of three Partnership Centers each led by US-based institutions (University of California San Francisco, Weill Medical College of Cornell University, and Fred Hutchinson Cancer Research Center), working collaboratively with US and LAC institutions and with the NCI to develop and conduct multicenter prevention clinical trials focused on filling key scientific gaps and evaluating novel interventions. Results: ULACNet encompasses six countries (US, Mexico, Puerto Rico, Brazil, Peru, and Dominican Republic), twenty partner institutions, and over 100 collaborating scientific investigators, clinical and public health practitioners, research staff, and patient advocates. ULACNet will collaboratively conduct nine prevention clinical trials (two prophylactic HPV vaccine trials in adults and perinatally-HIV infected adolescents, three trials for clinical validation of molecular biomarkers and imaging technologies for screening and triage, two candidate HPV therapeutic vaccine trials, and two trials of topical therapeutic agents). Facilitation across network partners is achieved via a Coordinating Committee and three Working Groups (focused on HPV testing and screening, precancer treatment, and recruitment and retention activities). Conclusion: ULACNet seeks to leverage established academic global health partnerships to conduct high quality collaborative clinical trials to inform clinical practice and ultimately reduce the burden of highly preventable HPV-related cancers in persons living with HIV worldwide. Citation Format: Emma Brofsky, Margaret House, Brandy Heckman-Stoddard, Mostafa Nokta, Satish Gopal, Vikrant Sahasrabuddhe. Development of International Cancer Research Partnerships Through the NCI US-Latin American-Caribbean HIV/HPV-Cancer Prevention Clinical Trials Network (ULACNet) [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 20.

Transregionalism in relations between Latin America and the European Union

Nowadays the globalized world faces new challenges, for instance, trade and economic contradictions between the main actors of the world politics (the USA and China, the USA and the EU). Amid this situation, Latin America could play the card, add momentum to the cross-regional contacts and considerably benefit from it. Fostering relations with the EU serves the national interests of Latin American countries, since the EU investment and technologies can be the tools to modernize the economy. The EU is the leader in implementing harmonization between regions. The relations between the EU and Latin America can be considered as a model of hybrid interregionalism. While bilateral relations or the ties of the EU with subregional integration associations remain strong, the relations between the EU and the entire Latin American and the Caribbean (LAC) region are still underdeveloped, and countries have been trying to rectify it recently.

Domestic revenue mobilisation in developing countries: An exploratory analysis of sub‐Saharan Africa and Latin America

AbstractThis study compares taxation trends, volatility and tax effort between sub‐Saharan Africa (SSA) and Latin American and the Caribbean (LAC) countries since 1980. It finds that the LAC countries lead on revenue collection and revenue stability, but richer SSA countries outperform their LAC counterparts. Since 2010, there has been a divergence on personal income taxes, which have grown in SSA but declined in the LAC. The panel analysis shows that tax determinants are sensitive to income levels. The study shows the importance of exploring diversity and cross‐regional variations on income levels. Additionally, it shows that room exists for peer‐to‐peer lessons on tax reforms.

Evaluation of the Digitalization Development level in the Latin-American Economy

Latin American and the Caribbean (LAC) countries have experienced an economic slowdown in the last five years, to accelerate economic growth, LAC countries need to find new instruments to transform the economy. digitalization in all sectors of the economy gives a boost to the country’s economic growth. Digital tools also promote access to better services, such as education, government management and the foreign trade sector. The article analyzes the current state of the digitalization of the economy in LAC. To determine the digitalization of the economy, only indicators found in official sources were included.

The value and impact of embedded implementation research: insights from Latin America and the Caribbean

[Extract ] Embedded research is carried out as an integrated and systematic part of health decisions and policymaking and implementation (1). It means continuous collaboration between decision-makers, researchers, and communities. Embedded research focuses on systems-level challenges and illuminates context-specific factors for real-world health programs, policy, and system decisions. It improves ownership and implementation (2). With this in mind, a joint initiative between the Alliance for Health Policy and Systems Research (Alliance HPSR), the Pan American Health Organization (PAHO), and the World Health Organization (WHO) Special Programme for Research and Training in Tropical Diseases (TDR) issued an open call for researchers and policy and decision-makers to identify challenges requiring embedded research to accelerate progress towards the SDGs in the Latin American and the Caribbean (LAC) region and provided technical cooperation throughout the process.[...]

­SDG3-Related Inequalities in Women’s, Children’s, and Adolescents’ Health: A Baseline for Latin America and the Caribbean

Background: Latin American and the Caribbean (LAC) countries have made important progress towards achieving the Sustainable Development Goal targets related to health (SDG3) at the national level. However, vast socioeconomic inequalities in health remain within countries. There is an urgent need for baseline data on inequalities against which progress towards the SDGs can be monitored. Methods: Data for 21 LAC countries were analyzed from Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Survey (MICS) carried out from 2011-2016. Related SDG3 indicators for women’s, children’s, and adolescents’ (WCA) health were computed. The analyses included stratification of indicators by household wealth quintiles, urban-rural residence, subnational regions and, when applicable, women’s education and age, and sex of the child. Absolute and relative inequalities were assessed. Results: In most countries, subnational geographic health gradients were observed for nearly all WCA indicators. Coverage of key interventions was higher in urban areas and among the richest, compared to rural areas and poorer quintiles. Analyses by woman’s age showed that coverage was lower in adolescent girls than older women for family planning indicators. Pro-urban and pro-rich inequalities were also seen for mortality in most countries. Interpretation: Regional averages hide important health inequalities between countries, but national estimates hide still greater inequalities between subgroups of women, children, and adolescents. To achieve the SDG3 targets and leave no one behind, it is essential to close health inequality gaps within as well as between countries. Funding Statement: The work was funded by the Pan American Health Organization (PAHO), who did not have any say in the design, analysis or writing. Declaration of Interests: None to declare Ethics Approval Statement: This manuscript is totally based in publicly available data and the ethical clearance and approval was obtained by the institutions responsible for the original studies.