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| 2. |
- Micah, Angela E., et al.
(författare)
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Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050
- 2021
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 398:10308, s. 1317-1343
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Forskningsöversikt (refereegranskat)abstract
- Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached $8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this, $13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and $1.4 billion was repurposed from existing health projects. $3.1 billion (22.4%) of the funds focused on country-level coordination and $2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34.3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
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- Feigin, Valery L., et al.
(författare)
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Global, regional, and national burden of stroke and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019
- 2021
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 20:10, s. 795-820
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Tidskriftsartikel (refereegranskat)abstract
- Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12.2 million (95% UI 11.0-13.6) incident cases of stroke, 101 million (93.2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6.55 million (6.00-7.02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11.6% [10.8-12.2] of total deaths) and the third-leading cause of death and disability combined (5.7% [5.1-6.2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70.0% (67.0-73.0), prevalent strokes increased by 85.0% (83.0-88.0), deaths from stroke increased by 43.0% (31.0-55.0), and DALYs due to stroke increased by 32.0% (22.0-42.0). During the same period, age-standardised rates of stroke incidence decreased by 17.0% (15.0-18.0), mortality decreased by 36.0% (31.0-42.0), prevalence decreased by 6.0% (5.0-7.0), and DALYs decreased by 36.0% (31.0-42.0). However, among people younger than 70 years, prevalence rates increased by 22.0% (21.0-24.0) and incidence rates increased by 15.0% (12.0-18.0). In 2019, the age-standardised stroke-related mortality rate was 3.6 (3.5-3.8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3.7 (3.5-3.9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62.4% of all incident strokes in 2019 (7.63 million [6.57-8.96]), while intracerebral haemorrhage constituted 27.9% (3.41 million [2.97-3.91]) and subarachnoid haemorrhage constituted 9.7% (1.18 million [1.01-1.39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79.6 million [67.7-90.8] DALYs or 55.5% [48.2-62.0] of total stroke DALYs), high body-mass index (34.9 million [22.3-48.6] DALYs or 24.3% [15.7-33.2]), high fasting plasma glucose (28.9 million [19.8-41.5] DALYs or 20.2% [13.8-29.1]), ambient particulate matter pollution (28.7 million [23.4-33.4] DALYs or 20.1% [16.6-23.0]), and smoking (25.3 million [22.6-28.2] DALYs or 17.6% [16.4-19.0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.
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| 4. |
- Lue, Charles, et al.
(författare)
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Chandrayaan-1 observations of backscattered solar wind protons from the lunar regolith : Dependence on the solar wind speed
- 2014
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Ingår i: Journal of Geophysical Research - Planets. - 2169-9097 .- 2169-9100. ; 119:5, s. 968-975
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Tidskriftsartikel (refereegranskat)abstract
- We study the backscattering of solar wind protons from the lunar regolith using the Solar Wind Monitor of the Sub-keV Atom Reflecting Analyzer on Chandrayaan-1. Our study focuses on the component of the backscattered particles that leaves the regolith with a positive charge. We find that the fraction of the incident solar wind protons that backscatter as protons, i.e., the proton-backscattering efficiency, has an exponential dependence on the solar wind speed that varies from similar to 0.01% to similar to 1% for solar wind speeds of 250km/s to 550km/s. We also study the speed distribution of the backscattered protons in the fast (similar to 550km/s) solar wind case and find both a peak speed at similar to 80% of the solar wind speed and a spread of similar to 85km/s. The observed flux variations and speed distribution of the backscattered protons can be explained by a speed-dependent charge state of the backscattered particles.
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| 6. |
- Lue, Charles, et al.
(författare)
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Scattering characteristics and imaging of energetic neutral atoms from the Moon in the terrestrial magnetosheath
- 2016
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Ingår i: Journal of Geophysical Research - Space Physics. - 2169-9380 .- 2169-9402. ; 121:1, s. 432-445
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Tidskriftsartikel (refereegranskat)abstract
- We study hydrogen energetic neutral atom (ENA) emissions from the lunar surface, when the Moon is inside the terrestrial magnetosheath. The ENAs are generated by neutralization and backscattering of incident protons of solar wind origin. First, we model the effect of the increased ion temperature in the magnetosheath (>10 times larger than that in the undisturbed solar wind) on the ENA scattering characteristics. Then, we apply these models to ENA measurements by Chandrayaan-1 and simultaneous ion measurements by Kaguya at the Moon, in the magnetosheath. We produce maps of the ENA scattering fraction, covering a region at the lunar near-side that includes mare and highland surfaces and several lunar magnetic anomalies. We see clear signatures of plasma shielding by the magnetic anomalies. The maps are made at different lunar local times, and the results indicate an extended influence and altered morphology of the magnetic anomalies at shallower incidence angles of the magnetosheath protons. The scattering fraction from the unmagnetized regions remains consistent with that in the undisturbed solar wind (10%-20%). Moreover, the observed ENA energy spectra are well reproduced by our temperature-dependent model. We conclude that the ENA scattering process is unchanged in the magnetosheath. Similarly to the undisturbed solar wind case, it is only magnetic anomalies that provide contrast in the ENA maps, not any selenomorphological features such as mare and highland regions.
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| 7. |
- Lue, Charles, et al.
(författare)
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Solar wind scattering from the surface of Mercury : Lessons from the Moon
- 2017
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Ingår i: Icarus. - : Elsevier BV. - 0019-1035. ; 296, s. 39-48
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Tidskriftsartikel (refereegranskat)abstract
- We discuss the surface-scattering of solar wind protons at Mercury based on observed scattering characteristics from lunar regolith. The properties of the impinging plasma are expected to be different between different regions on Mercury, and between Mercury and the Moon. Here, we review the expected Hermean plasma conditions and lunar empirical scattering models. We present observed and modeled energy spectra for scattered protons and hydrogen energetic neutral atoms (ENAs) for three cases of very different plasma conditions at the Moon. Then, we simulate scattering from the Hermean surface by applying the empirical models to four different scenarios of plasma precipitation on Mercury. The results suggest that surface-scattering is a strong source of ENAs at Mercury (up to similar to 10(8) cm(-2) s(-1)), which can be very useful for remote-sensing of the plasma conditions at the surface. Protons scattered from the surface back into space are also expected with high fluxes up to similar to 10(7) cm(-2) s(-1), and may be important for wave generation and the filling in of the loss cone of mirroring and quasi-trapped populations. Scattered protons at the cusp region (of similar to 10(6) cm(-2) s(-1)) can potentially be detected by orbiters as outflowing protons within the loss cone.
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| 8. |
- Lue, Charles, et al.
(författare)
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Strong influence of lunar crustal fields on the solar wind flow
- 2011
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Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 38:3
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Tidskriftsartikel (refereegranskat)abstract
- We discuss the influence of lunar magnetic anomalies on the solar wind and on the lunar surface, based on maps of solar wind proton fluxes deflected by the magnetic anomalies. The maps are produced using data from the Solar WInd Monitor (SWIM) onboard the Chandrayaan-1 spacecraft. We find a high deflection efficiency (average ∼10%, locally ∼50%) over the large-scale (>1000 km) regions of magnetic anomalies. Deflections are also detected over weak (<3 nT at 30 km altitude) and small-scale (<100 km) magnetic anomalies, which might be explained by charge separation and the resulting electric potential. Strong deflection from a wide area implies that the magnetic anomalies act as a magnetosphere-like obstacle, affecting the upstream solar wind. It also reduces the implantation rate of the solar wind protons to the lunar surface, which may affect space weathering near the magnetic anomalies.
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