Place in Therapy of the Newly Available Armamentarium for Multi-Drug-Resistant Gram-Negative Pathogens: Proposal of a Prescription Algorithm

The worldwide propagation of antimicrobial resistance represents one of the biggest threats to global health and development. Multi-drug-resistant organisms (MDROs), including carbapenem-resistant non-fermenting Gram-negatives and Enterobacterales, present a heterogeneous and mutating spread. Infections by MDRO are often associated with an unfavorable outcome, especially among critically ill populations. The polymyxins represented the backbone of antibiotic regimens for Gram-negative MDROs in recent decades, but their use presents multiple pitfalls. Luckily, new agents with potent activity against MDROs have become available in recent times and more are yet to come. Now, we have the duty to make the best use of these new therapeutic tools in order not to prematurely compromise their effectiveness and at the same time improve patients’ outcomes. We reviewed the current literature on ceftazidime/avibactam, meropenem/vaborbactam and cefiderocol, focusing on antimicrobial spectrum, on the prevalence and mechanisms of resistance development and on the main in vitro and clinical experiences available so far. Subsequently, we performed a step-by-step construction of a speculative algorithm for a reasoned prescription of these new antibiotics, contemplating both empirical and targeted use. Attention was specifically posed on patients with life-risk conditions and in settings with elevated prevalence of MDRO.

A Body of Knowledge and Pedagogy for Global Engineering

Global engineers must be taught to consider the historical and present causes of persistent poverty and systematic barriers to prosperity. Such training will better inform the choices engineers make and help move the engineering sector away from a product and community-level focus towards working to address the root causes of poverty. A framing for Global Engineering has recently been proposed by the Mortenson Center in Global Engineering at the University of Colorado Boulder, building on over 15 years of curricular efforts. Global Engineering, as taught by the Mortenson Center, positions the field as a complement to Global Health and Development Economics while further embracing a historically contextualized and anti-colonial training.

An analysis of funding patterns in development assistance for mental health: who, when, what, and where

Background Mental health has recently gained increasing attention on global health and development agendas, including calls for an increase in international funding. Few studies have previously characterized official development assistance for mental health (DAMH) in a nuanced and differentiated manner in order to support future funding efforts. Methods Data from the Organisation for Economic Cooperation and Development Creditor Reporting System were obtained through keyword searches. Projects were manually reviewed and categorized into projects dedicated entirely to mental health and projects that mention mental health (as one of many aims). Analysis of donor, recipient, and sector characteristics within and between categories was undertaken cumulatively and yearly. Findings Between the two categories of official DAMH defined, characteristics differed in terms of largest donors, largest recipient countries and territories, and sector classification. However, across both categories there were clear and consistent findings: the top donors accounted for over 80% of all funding identified; the top recipients were predominantly conflict-affected countries and territories, or were receiving nations for conflict-affect refugees; and sector classification demonstrated shifting international development priorities and political drivers. Conclusion Across DAMH, significant amounts of funding are directed toward conflict settings and relevant emergency response by a small majority of donors. Our analysis demonstrated that, within minimal international assistance for mental health overall, patterns of donor, recipient, and sector characteristics favor emergency conflict-affected settings. Calls for increased funding should be grounded in understanding of funding drivers and directed toward both emergency and general health settings.

Becoming a target of HIV intervention

This think piece asks readers to consider how the science of anthropology has contributed to (re)categorization and imaginaries of gender, class, and the state in the context of public and global health interventions. Anthropological work on HIV has since its inception questioned the public health categories of those considered at highest risk for HIV, while simultaneously helping to reconstitute those categories, as well as definitions of risk, especially in relation to the concept of vulnerability. While anthropological research on HIV is replete with critiques of categorization as a mode of governance, most often in reference to global health and development apparatuses, anthropologists rarely reflect on the role the discipline might play in co-creating those categories to ‘make up people’ and reproduce geopolitical norms. The propositions I lay out in this think piece stem from my experience researching the emergence of public and global health categories in various national settings in eastern and southern Africa win the context of HIV interventions.

Rethinking global mental health and its priorities

Global mental health (GMH) seems to enjoy increasing visibility in the global health and development discourse. However, this visibility implies also the urgency of addressing few questions about new priority setting in the domains of policy, care delivery, service organisation and research. Even before trying to answer these questions, rethinking more deeply the notion and implications of GMH seems to be a useful collective exercise. Some unanswered questions should be at the core of this exercise: Is GMH really global or rather Western? Is GMH concerned enough with local context? Is GMH too unbalanced towards a biomedical model? What are the consequences of the predominant emphasis given by GMH on common mental disorders and primary care level on people with severe mental disabilities? GMH is not global but rather it is hegemonised by western institutions. It would be useful to have an independent and very inclusive think tank which should promote a global debate on these issues and offer an unbiased support to WHO.

Conducting Benefit-Cost Analysis in Low- and Middle-Income Countries: Introduction to the Special Issue

Investing in global health and development requires making difficult choices about what policies to pursue and what level of resources to devote to different initiatives. Methods of economic evaluation are well established and widely used to quantify and compare the impacts of alternative investments. However, if not well conducted and clearly reported, these evaluations can lead to erroneous conclusions. Differences in analytic methods and assumptions can obscure important differences in impacts. To increase the comparability of these evaluations, improve their quality, and expand their use, this special issue includes a series of papers developed to support reference case guidance for benefit-cost analysis. In this introductory article, we discuss the background and context for this work, summarize the process we are following, describe the overall framework, and introduce the articles that follow.

An Emergent Sociology of Global Health and Development

Sociologists have much to contribute to the study of global health and development. Our discipline's fundamental concerns with power and inequality uniquely position us to leverage theoretical, conceptual, substantive, and empirical insights for the understanding of engines, outcomes, and processes of global health and development. This special issue highlights the diversity and depth of sociological engagements with the topics of global health and development. In this introduction to this special issue, I briefly outline how sociologists have approached the study of global health and development despite the fact that this is a nascent and not yet fully coalesced field. While medical sociologists and political sociologists have historically studied these topics, they have also marginalized them. Exciting sociological research is, however, underway. The challenge is in ensuring that scholarship on global health and development is in conversation across subfields in order to propel research on global health and development forward, both substantively and theoretically.

Conference Proceeding for the 6th Annual Action Global Health Network Conference: A Student-led Movement Encouraging Advocacy, Research and Outreach

On September 30th, 2017, medical students from the University of Ottawa organized and attended the 6th annual Action Global Health Network Conference (AGHN), in collaboration with the Faculty of Medicine. This full-day event aimed to challenge perceptions about global health and development, and encouraged participants to explore global health and social medicine as an avenue to improve equity. This conference proceeding recounts the key components of the 6th annual AGHN Conference, including keynote speakers, workshop speakers, and the research symposium. Core themes, learning takeaways, and future planning are also discussed in hopes of inspiring similar student-led initiatives across campuses.