Enis Baris

Healthcare in Turkey: from laggard to leader

Enis Baris and colleagues observe that a political commitment to universal health coverage together with a significant investment in health has seen Turkey’s health indicators catch up and surpass other middle income countries

Community effectiveness of stove and health education interventions for reducing exposure to indoor air pollution from solid fuels in four Chinese provinces

Indoor air pollution (IAP) from biomass and coal is a leading cause of mortality and disease burden in the developing world. There is limited evidence of the community effectiveness of interventions for reducing IAP exposure. We conducted a community-based intervention study of stove and health education interventions in four low-income Chinese provinces: Gansu, Guizhou, Inner Mongolia, and Shaanxi. Separate townships in one county in each province were assigned to stove plus behavioral interventions, behavioral interventions alone, and control. Data on household fuel and stove use, and on concentrations of respirable particles (RPM), carbon monoxide (CO), and sulfur dioxide (SO2), were collected in peak and late heating seasons before and after interventions. The effectiveness of interventions was evaluated using difference-in-difference analysis. Pollutant concentrations were also measured in controlled tests, in which stoves were operated by expert users. In controlled tests, there was consistent and substantial reduction in concentrations of RPM (>88%) and CO (>66%); in the two coal-using provinces, SO2 concentrations declined more in Shaanxi than in Guizhou. In community implementation, combined stove and behavioral interventions reduced the concentrations of pollutants in rooms where heating was the main purpose of stove use in the peak heating season, with smaller, non-significant, reduction in late heating season. Gansu was the only province where combined stove and behavioral interventions led to pollution reduction where cooking was the primary purpose of stove use. Compared to the control group, no significant IAP reductions were seen in groups with health education alone.

Should interventions to reduce respirable pollutants be linked to tuberculosis control programmes

The potential benefits of linking tuberculosis control programmes with interventions to reduce smoking and indoor air pollution make research to improve our understanding of their relation a high priority

Assessing the global economic and poverty effects of antimicrobial resistance

This paper assesses the potential impact of antimicrobial resistance on global economic growth and poverty. The analysis uses a global computable general equilibrium model and a microsimulation framework that together capture impact channels related to health, mortality, labor productivity, health care financing, and production in the livestock and other sectors. The effects spread across countries via trade flows that may be affected by new trade restrictions. Relative to a world without antimicrobial resistance, the losses during 2015–50 may sum to

Geographical, spatial, and temporal distributions of multiple indoor air pollutants in four Chinese provinces.

85 trillion in gross domestic product and

Exposure to indoor air pollution from household energy use in rural China: the interactions of technology, behavior, and knowledge in health risk management.

23 trillion in global trade (in present value). By 2050, the cost in global gross domestic product could range from 1.1 percent (low case) to 3.8 percent (high case). Antimicrobial resistance is expected to make it more difficult to eliminate extreme poverty. Under the high antimicrobial resistance scenario, by 2030, an additional 24.1 million people would be extremely poor, of whom 18.7 million live in low-income countries. In general, developing countries will be hurt the most, especially those with the lowest incomes.