United Nations Targets Research Articles

Loss to Follow-up and Death Among Individuals With Newly Diagnosed Human Immunodeficiency Virus Receiving Dolutegravir-Based First-Line Antiretroviral Treatment in Eastern Ethiopia: Implications for 95% United Nations Targets.

Loss to follow-up (LTFU) and death are unfavorable outcomes of human immunodeficiency virus (HIV) treatment. This study aimed to identify the predictors of LTFU and death among individuals with newly diagnosed HIV receiving dolutegravir (DTG)-based first-line antiretroviral treatment (ART) in eastern Ethiopia. A multisite prospective cohort study was carried out between October 2020 and July 2022. New case patients who started ART were enrolled consecutively and then followed up for the next 6 months. A structured questionnaire and checklists were used to collect data. HIV viral load was determined using the Abbott RealTime HIV-1 assay. Bivariable and multivariable logistic regression models were used to identify baseline factors associated with the outcomes. A total of 235 people with newly diagnosed HIV were enrolled; 16.6% (95% confidence interval, 12.3%-21.9%) were lost to follow-up, and 5.9% (3.5%-9.8%) died within 6 months of follow-up. Baseline World Health Organization clinical stage I (adjusted odds ratio, 3.93 [95% confidence interval, 1.34-11.57]), low viral load (3.67 [1.09-12.36]), and body weight (1.04 [1.01-1.07]) were predictors of LTFU, whereas nonfunctional status (10.02 [1.9-51.3]) was the only factor associated with death. LTFU and death rates among patients with DTG were relatively high, accounting for roughly a quarter of the attrition of people with newly diagnosed HIV from ART care and services. Thus, targeted interventions are required to reduce LTFU and death among individuals with HIV on ART. Further investigation is necessary to evaluate the long-term effects of DTG-based regimens on LTFU and its impact on HIV mortality rates, and qualitative research, specifically tracing LTFU, is recommended.

The Infomóvel—An information system for managing HIV/AIDS patients in rural areas of Mozambique

BackgroundMobile health is gradually revolutionizing the way medical care is delivered worldwide. In Mozambique, a country with a high human immunodeficiency virus prevalence, where antiretroviral treatment coverage is 77% accompanied by a 67% of retention rate, the use of mobile health technology may boost the antiretroviral treatment, by delivering care beyond health facilities and reaching underrepresented groups. Leveraging new technologies is crucial to reach the 95–95-95 United Nations target by 2030. The design, development, implementation, and evaluation of a mobile health platform called Infomóvel were covered in this article. Its intended use involves collaboration with community health workers and aims to increase human immunodeficiency virus patient access, adherence, and retention to care.MethodsUsing the Design Science Research Methodology, Infomóvel was created, as well as this publication. The explanation of various actions includes everything from problem description to observational study and goal-following for a solution, which results in the design and development of a platform proposal. Before the utility assessment of Infomóvel was conducted to make adjustments, a demonstration phase was conducted in one region of Mozambique.ResultsThe initial subjects of the Infomóvel flowchart and physical process design were patients receiving antiretroviral medication who were enrolled in the patients tracking system and who had consented to home visits. The case manager examines the file before importing it into the Infomóvel database stored on a cloud server using the website www.commcarehq.org. The case manager application synchronises with the Infomóvel server database, enabling the import of latest data and access to the lists of new patients and community health workers. The community health worker uses his phone to access his application, which allows him to record the geographic coordinates and sort the list of patients by priority and type of visit.ConclusionResults from Infomóvel add to the growing body of data showing that mobile health techniques are beneficial for managing stable individuals with chronic conditions in Mozambique. These approaches can be scaled up and better utilised. However, additional studies should be conducted to quantify the resources needed to implement on a larger scale.

Machine Learning-based maternal health risk prediction model for IoMT framework

The Internet of Things (IoT) is vital as it offers extensive applicability in various fields, including healthcare. In the context of the risk level during pregnancy, to monitor and predict abnormalities, IoT devices provide a means to collect real-time health data, enabling continuous monitoring and analysis in the Internet of Medical Things (IoMT) environments. By integrating IoT devices into the system, crucial signs such as Heart Rate (HR), Systolic and Diastolic Blood Pressure (BP), Fetal Movements (FM), and Temperature (T) can be tracked remotely and non-invasively. This allows for the timely detection of abnormalities or potential risk factors during pregnancy, empowering healthcare professionals to intervene proactively and provide personalized care. This research focuses on developing a system for observing and predicting the maternal risk level in the IoT environment, mainly in remote areas. The goal is to improve maternal health and reduce maternal and child mortality rates, a significant decline according to United Nations targets for 2030. The research utilizes analytical tools and Machine Learning (ML) algorithms to analyze health data and risk factors associated with pregnancy. The acquired dataset contains various risk factors categorized and classified based on intensity. After comparing different ML models’ experimental results, Exploratory Data Analysis (EDA) approaches to determine the most effective risk factors. The fine-tuned Random Forest Classifier (RF) achieves the highest accuracy of 93.14%. An Android-based application has also been developed to deploy the prediction model to determine risk levels based on the different parameters.

Health and economic benefits of achieving contraceptive and maternal health targets in Small Island Developing States in the Pacific and Caribbean

IntroductionReducing unmet need for modern contraception and expanding access to quality maternal health (MH) services are priorities for improving women’s health and economic empowerment. To support investment decisions, we estimated...

Sungai Subang Rehabilitation Methods towards a Liveable and Integrated Environment Approach

Ensure the availability and sustainable management of water and sanitation for all nations aim to the Sustainable Development Goal 6 (SDG) formed under the 2030 Agenda for Sustainable Development. The current United Nations (UN) report release stated that the UN targets all people to enjoy access to freshwater in its quality and quantity. Hence, achieving the goal is one of the significant challenges to all governments by 2030. In tandem with vast industrial development and an increase in its population, Malaysia is one of the developed countries facing water sufficiency issues regarding its quality and management. This study believes that poor water management, lack of public awareness, vast development, urbanisation, lack of integration, and a holistic approach are the leading causes of water quality depletion in Malaysia. Responding to the issues mentioned above, water sustainability approaches are believed to be one of the solutions to tackle the problems in this study. The data were gathered using qualitative methods of i) Document analysis and ii) Site inventory. It has taken place in Sg. Subang, one of the polluted rivers, and this project applied sustainable water approaches in its design to overcome the existing river issues. Hence, the river becomes part of the open spaces to serve the nearby residence.

Digitalisation as the Indicator of the Evidence of Sustainability in the European Union

Digitalisation provides access to an integrated network of information that can benefit society and businesses. However, the evidence of sustainability in business is less researched. In our paper, by building up the research approach, we address the relevant gap by investigating how sustainable development goals represent the interrelationship between digitalisation and sustainability. Such research is particularly important because understandings of digitalisation and sustainability determine how different actors, including business managers and policymakers, act in response to those imperatives to develop future employees skills starting from school age. Following a multi-method approach, we have combined our analysis into two steps examining the relationship between digitalisation and sustainability. Building digital networks, business managers and policy makers using digital means can create some unique opportunities to strategically address sustainable development challenges for the United Nations Targets (SDG) to ensure higher productivity, education, and an equality-oriented society. This point of view describes the potential of digitalisation for society and businesses of the future. The authors revise the links between digitalisation and sustainability in the European Union countries by using data available in Eurostat and UNECE public databases. The two-stage methodology for the identification of the relationship between ICT and sustainability is used in the paper and a linear regression model is applied. The results showed tiers with five SDGs, focusing on business, and all these tiers are fixed in the constructed equations for each SDG. The recommended solution is statistically valid and proves the novelty of this research. Among digitalisation indicators, only mobile-cellular subscriptions and fixed-broadband sub-basket prices in part do not affect researched sustainable development indicators.

How the RPS can improve sustainability

Climate change, sustainability, global warming, climate emergency and recycling are all words we have seen recently. What is clear however, is that there is a climate emergency and pharmacy has to play its part in helping achieve the United Nations target of a 1.5 degree Celsius reduction in global warming by 2030. The RPS has recently […]

Edible Insects: Sustainable nutrient-rich foods to tackle food insecurity and malnutrition

The COVID-19 pandemic, global climate change, and a fast-growing human population have been reported to be leading millions into food insecurity. According to an FAO report, in 2020 over 811 million people were undernourished with 418 million in Asia, 282 million in Africa and 60 million in Latin America and the Caribbean. The world is off-track in ending hunger and improving nutrition, targets set by the United Nations (UN), to be achieved by 2030. The promotion of sustainable food sources such as entomophagy can help to deliver sustainable nutrition to many populations to reach the aforementioned UN targets. This narrative review explores the existing evidence around the use of edible insects to address food insecurity and malnutrition, including health, social and environmental benefits. For example, the house cricket (Acheta domesticus) provides on the order of three times as much energy, protein, and iron as an equal amount of beef or chicken and, unlike them, is an excellent source of calcium. An effective decontamination technique (to address safety issues such as allergens and pathogens) is required to produce edible insect powder. Insect powder can be used to effectively fortify conventional food products with iron, zinc, calcium and dietary fibre, which are often difficult to obtain in adequate amounts in many common dietary regimes, especially in low-income circumstances. In communities where the consumption of insects is already culturally accepted, promotion of their consumption could also help address chronic diseases related to poor diets such as type 2 diabetes. In addition to their high nutrient content, many edible insects provide anti-inflammatory factors. Supporting the harvesting and even rearing of edible insects could generate increased income from selling them in local markets.

Packaging Innovations to Reduce Food Loss and Waste: Are Italian Manufacturers Willing to Invest?

The target 12.3 of the 2030 Agenda by the United Nations (UN) calls for halving per capita global food loss and waste. In this regard, the Food & Drink industry (F&D) could play a crucial role in reducing food waste and improving food safety by adopting healthy and eco-innovation packaging. Thus, this paper aims to investigate the F&D manufacturers’ willingness to invest in packaging innovations, such as active, intelligent, and compostable ones to achieve the UN target. In order to reach the stated objective, a multiple case study methodology was developed and administered to a sample of Italian micro and small-medium entrepreneurs located in the Apulia region. Results show that many firms were aware of their need for packaging innovation and of the available technological opportunity. However, only the F&D manufacturers who showed a Real demand, according to a taxonomy approach which also considers the Potential and Latent demand for the innovation, were effectively prompt to invest. Finally, most of the interviewed manufacturers were willing to invest in at least one packaging innovation, choosing mainly between the active packaging and the compostable one.

Reducing the Harmful Use of Alcohol: Have International Targets Been Met?

Alcohol use has been identified in major United Nations (UN) initiatives, such as the Sustainable Development Goals and the Non-Communicable Disease Action Plan, as a major contributor to the global burden of disease. As a result, levels of alcohol use serve as an official indicator of progress towards these UN-set goals. Given current trends, UN targets for reduced alcohol consumption are unlikely to be met. Moreover, in many countries, especially in low- and middle-income countries, the alcohol-attributable burden of disease continues to increase. Pressure will need to be exerted on national and international decision-makers to arrive at more powerful and normatively persuasive instruments, such as a treaty.

Economic growth, population health and Sustainable Development Goal 8

Abstract High-income countries (HICs), including UK, Germany and Japan, are reducing CO2 output relative to economic growth. SDG8 refers to 'sustainable growth' but does not differentiate between low, middle- and high-income countries. The United Nations target is for net-zero CO2 emissions by 2050, therefore there is a strong case for exploring the implications of low or zero economic growth among HICs as a mechanism for limiting climate change. A key consideration is whether progress in population health would stall if HIC economies stopped growing. We examined headline health statistics among HIC countries for evidence of divergence in health trends. We looked for associations between trajectories of national economies and health trends over the past four decades. Age-standardised death rates were calculated from all-cause and cause-specific rates in the WHO mortality database. All-cause mortality (ACM) rates declined in parallel in UK, France and Japan, from about 700 to 400/100,000 in the period 1980-2010, with the lowest rates in Japan. Decline in the ACM rate in USA was shallower 1980-2010. In the decade of austerity following the banking crisis, the ACM rate in USA and UK stopped declining. The Japanese ACM rate continued its rapid post-war decline in the two decades of economic stagnation after 1990. Trends in Japanese coronary heart disease, stroke and cancer mortality rates, but not those for suicide, were consistently favourable in the recent period. The natural before-and-after experiment in Japan, of high economic growth in the decades to 1990, and low growth after 1990, is an example of a HIC with continuing progress in population health in a long period of low growth. Repeat measures of subjective, self-rated health from a population-based Japanese survey series (1986-2013) add to the evidence from objective mortality rate trends. Progress in population health does not need to stall if HIC economies focus on combatting climate change instead of growth.

A review of progress and opportunities to foster development of sustainability-related competencies in engineering education

ABSTRACTOver the last decade and prompted by the United Nations (UN) 2030 Framework, significant engineering bodies have been calling for education directed towards achieving the UN Sustainable Development Goals (SDGs). In this paper, the authors reflect on progress to enable SDG knowledge and skills in engineering studies, overviewing key examples of efforts within the global professional engineering and education community, including Australia and the United States of America (the US). Acknowledging differences in language and guidance around the world, the authors discuss the need to provide clear and concise language regarding: 1) statements for desirable graduate attributes, 2) required knowledge and skill (i.e. competency) development, and 3) commentary/guiding elements and indicators. The paper concludes with recommending accreditation bodies and professional societies and colleges make use of current international review processes underway by the International Engineering Alliance (IEA) and the World Federation of Engineering Organisations (WFEO), to update accreditation and supporting documents to ensure graduates have capacity to deliver solutions for ‘thriving humanity and planet’ in the twenty-first century. The authors also challenge educators to review and renew their institution’s desired graduate attributes and program offerings to ensure curriculum develops capacity for achieving the UN SDG goals, targets and indicators.

Progress towards the United Nations 90-90-90 and 95-95-95 targets: the experience in British Columbia, Canada.

IntroductionAntiretroviral therapy (ART) scale‐up is central to the global strategy to control the HIV/AIDS pandemic. To accelerate efforts towards ending the AIDS epidemic, the Joint United Nations Programme on HIV/AIDS released the 90‐90‐90 and 95‐95‐95 targets, which have recently been approved by the United Nations (UN). This study characterizes the province of British Columbia (BC)'s progress towards achieving the UN targets, predicts a trajectory up to 2030 according to each of the individual steps (i.e. %Diagnosed, %On ART and %Virologically Suppressed), and identifies the population sub‐groups at higher risk of not achieving these targets.MethodsThe analyses were based on linked individual‐level datasets of people living with HIV (PLWH) in BC, aged ≥18 months, from 2000 to 2013. Using past trends in HIV prevalence and of each individual UN targets, we forecasted these outcomes until 2030 via generalized additive models. We ran a second set of analyses to assess the associations between individual demographic and behavioural factors and each of the individual steps of the UN targets. Lastly, we performed sensitivity analyses to account for uncertainty associated with prevalence estimates and suppression definitions.ResultsAmong the estimated 10666 PLWH in BC in 2013, 82% were diagnosed, 76% of those diagnosed were on ART and 83% of those on ART were virologically suppressed. We identified that females, PLWH aged <30 years and those with unknown risk or who self‐identify as having a history of injection drug use were the population subgroups that experienced the most challenge in engaging on ART and achieving viral suppression. Our model projections suggest that BC will achieve 90%‐91%‐90% and 97%‐99%‐97% by 2020 and 2030 respectively.ConclusionsAs we approach 2020, BC is rapidly moving towards achieving the UN targets. However, region‐specific challenges persist. Identification of remaining regional challenges will be essential to achieving the proposed UN targets and therefore fulfilling the promise to end AIDS as a pandemic by 2030.

The Heart of 25 by 25: Achieving the Goal of Reducing Global and Regional Premature Deaths From Cardiovascular Diseases and Stroke: A Modeling Study From the American Heart Association and World Heart Federation.

In 2011, the United Nations set key targets to reach by 2025 to reduce the risk of premature noncommunicable disease death by 25% by 2025. With cardiovascular disease being the largest contributor to global mortality, accounting for nearly half of the 36 million annual noncommunicable disease deaths, achieving the 2025 goal requires that cardiovascular disease and its risk factors be aggressively addressed. The Global Cardiovascular Disease Taskforce, comprising the World Heart Federation, American Heart Association, American College of Cardiology Foundation, European Heart Network, and European Society of Cardiology, with expanded representation from Asia, Africa, and Latin America, along with global cardiovascular disease experts, disseminates information and approaches to reach the United Nations 2025 targets. The writing committee, which reflects Global Cardiovascular Disease Taskforce membership, engaged the Institute for Health Metrics and Evaluation, University of Washington, to develop region-specific estimates of premature cardiovascular mortality in 2025 based on various scenarios. Results show that >5 million premature CVD deaths among men and 2.8 million among women are projected worldwide by 2025, which can be reduced to 3.5 million and 2.2 million, respectively, if risk factor targets for blood pressure, tobacco use, diabetes mellitus, and obesity are achieved. However, global risk factor targets have various effects, depending on region. For most regions, United Nations targets for reducing systolic blood pressure and tobacco use have more substantial effects on future scenarios compared with maintaining current levels of body mass index and fasting plasma glucose. However, preventing increases in body mass index has the largest effect in some high-income countries. An approach achieving reductions in multiple risk factors has the largest impact for almost all regions. Achieving these goals can be accomplished only if countries set priorities, implement cost-effective population wide strategies, and collaborate in public-private partnerships across multiple sectors.

The Heart of 25 by 25: Achieving the Goal ofReducing Global and Regional Premature Deaths From Cardiovascular Diseases and Stroke: A Modeling Study From the American Heart Association and WorldHeart Federation.

In 2011, the United Nations set key targets to reach by 2025 to reduce the risk of premature noncommunicable disease death by 25% by 2025. With cardiovascular disease being the largest contributor to global mortality, accounting for nearly half of the 36 million annual noncommunicable disease deaths, achieving the 2025 goal requires that cardiovascular disease and its risk factors be aggressively addressed. The Global Cardiovascular Disease Taskforce, comprising the World Heart Federation, American Heart Association, American College of Cardiology Foundation, European Heart Network, and European Society of Cardiology, with expanded representation from Asia, Africa, and Latin America, along with global cardiovascular disease experts, disseminates information and approaches to reach the United Nations 2025 targets. The writing committee, which reflects Global Cardiovascular Disease Taskforce membership, engaged the Institute for Health Metrics and Evaluation, University of Washington, to develop region-specific estimates of premature cardiovascular mortality in 2025 based on various scenarios. Results show that >5 million premature CVD deaths among men and 2.8 million among women are projected worldwide by 2025, which can be reduced to 3.5 million and 2.2 million, respectively, if risk factor targets for blood pressure, tobacco use, diabetes mellitus, and obesity are achieved. However, global risk factor targets have various effects, depending on region. For most regions, United Nations targets for reducing systolic blood pressure and tobacco use have more substantial effects on future scenarios compared with maintaining current levels of body mass index and fasting plasma glucose. However, preventing increases in body mass index has the largest effect in some high-income countries. An approach achieving reductions in multiple risk factors has the largest impact for almost all regions. Achieving these goals can be accomplished only if countries set priorities, implement cost-effective population wide strategies, and collaborate in public-private partnerships across multiple sectors.

Recent Evidence for Emerging Digital Technologies to Support Global HIV Engagement in Care.

Antiretroviral therapy is a powerful tool to reduce morbidity and mortality for the 35 million people living with HIV globally. However, availability of treatment alone is insufficient to meet new UNAIDS 90-90-90 targets calling for rapid scale-up of engagement in HIV care to end the epidemic in 2030. Digital technology interventions (mHealth, eHealth, and telehealth) are emerging as one approach to support lifelong engagement in HIV care. This review synthesizes recent reviews and primary studies published since January 2014 on digital technology interventions for engagement in HIV care after diagnosis. Technologies for health provide emerging and proven solutions to support achievement of the United Nations targets for the generalized HIV-affected population. Much of the existing evidence addresses antiretroviral therapy (ART) adherence; however, studies have begun to investigate programs to support linkage and retention in care as well as interventions to engage key populations facing extensive barriers to care.

Estimates of Global and Regional Premature Cardiovascular Mortality in 2025

United Nations member states have agreed to reduce premature cardiovascular disease (CVD) mortality 25% by 2025. Global CVD risk factor targets have been recommended. We produced estimates to show how selected risk factor reduction would affect CVD mortality for different regions and countries. We used mortality, risk factor, and relative risk data from the Global Burden of Disease, Risk Factors, and Injuries (GBD) 2013 study to project CVD mortality for 188 countries up to the year 2025. We disaggregated observed CVD mortality in 1990 and 2013 into deaths attributable and unattributable to hypertension, tobacco smoking, diabetes mellitus, and obesity using an age- and sex-specific population-attributable fraction. Risk factors were projected to 2025 assuming that current trends continue. Counterfactual scenarios were then constructed reflecting CVD premature mortality if United Nations risk factor targets are achieved in the year 2025, adjusting for joint effects of risk factors. We estimate 7.8 million premature CVD deaths in 2025 if current risk factor trends continue. Premature CVD deaths would be reduced to 5.7 million if these risk factors targets are achieved as a result of a 26% reduction for men and a 23% reduction for women in the global risk of premature CVD death. Globally, decreasing the prevalence of hypertension accounted for the largest risk reduction, followed by a reduction in tobacco smoking for men and obesity for women, but these results varied by region. The impact of meeting all risk factor targets on CVD mortality varied widely by region and sex. The United Nations target of a 25% reduction in premature CVD mortality by the year 2025 appears achievable for some countries, but more aggressive risk factor targets may be required if all regions are to reach this goal. Without these reductions in CVD risk factors, many countries will see no change or even an increase in premature CVD mortality.

The World Hypertension League challenges hypertension and cardiovascular organizations to develop strategic plans for the prevention and control of hypertension.

The World Hypertension League challenges hypertension and cardiovascular organizations to develop strategic plans for the prevention and control of hypertension.

Resources for Blood Pressure Screening Programs in Low Resource Settings: A Guide From the World Hypertension League.

Resources for Blood Pressure Screening Programs in Low Resource Settings: A Guide From the World Hypertension League.

Drinking water infrastructure in the Ashanti Region of Ghana: developing a model for sustainable interventions by non-governmental organizations

Access to clean water plays a critical role in advancing health in low- and middle-income countries. Over the past decade, Ghana has met United Nations targets for expanding access to clean water. Non-governmental organizations (NGOs) have taken part in this achievement; however, they have done so with varying success. In 2013, researchers from the University of Chicago, accompanied by local partners, visited seven villages in the Ashanti Region in which a Ghanaian NGO had installed boreholes for drinking water access. Household and leader questionnaires were administered to examine the impact of the project on each community. Four additional villages, which utilize surface water, were visited to establish baseline health and sanitation characteristics. Water samples were collected from primary drinking water sources and tested for coliforms. Two out of seven NGO wells were non-functional and over 35% of respondents cited broken pipes as common problems. Nonetheless, over 60% of respondents reported that a borehole had reduced their water collection time by a median of 30 minutes daily. Coliform counts were lower in samples taken from boreholes relative to samples taken from communities using surface water. Finally, we found redundant water services in many communities and no formalized approach to borehole maintenance.