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Over 1 in 3 people affected by neurological conditions, the leading cause of illness and disability worldwide

WHO news - 15.03.2024

A major new study released by The Lancet Neurology shows that, in 2021, more than 3 billion people worldwide were living with a neurological condition. The World Health Organization (WHO) contributed to the analysis of the Global Burden of Disease, Injuries, and Risk Factor Study (GBD) 2021 data.

Neurological conditions are now the leading cause of ill health and disability worldwide. The overall amount of disability, illness and premature death (known as disability-adjusted life years, DALYs) caused by neurological conditions has increased by 18% since 1990.

Over 80% of neurological deaths and health loss occur in low- and middle-income countries, and access to treatment varies widely: high-income countries have up to 70 times more neurological professionals per 100 000 people than low- and middle-income countries.

“Neurological conditions cause great suffering to the individuals and families they affect, and rob communities and economies of human capital,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This study should serve as an urgent call to action to scale up targeted interventions to allow the growing number of people living with neurological conditions to access the quality care, treatment and rehabilitation they need. It is more important than ever to ensure brain health is better understood, valued and protected, from early childhood to later life.”

The top ten neurological conditions contributing to loss of health in 2021 were stroke, neonatal encephalopathy (brain injury), migraine, dementia, diabetic neuropathy (nerve damage), meningitis, epilepsy, neurological complications from preterm birth, autism spectrum disorder, and nervous system cancers.

Overall, neurological conditions cause more disability and health loss in men compared to women, but there are some conditions like migraine or dementia where women are disproportionately affected.

Since 1990, the absolute number of individuals living with, or dying from, neurological conditions has increased, while age-standardized DALY rates have dropped. This means that increases in absolute numbers are mainly driven by demographic change and people living longer.

Diabetic neuropathy was the fastest growing neurological condition. The number of people with diabetic neuropathy has more than tripled globally since 1990, rising to 206 million cases in 2021. This increase is in line with the worldwide increase in diabetes. Other conditions such as neurological complications from COVID-19 (for example, cognitive impairment and Guillain-Barré syndrome) did previously not exist and now account for over 23 million cases.

At the same time, neurological burden and health loss due to other conditions decreased by 25% or more since 1990 as a result of improved prevention (including vaccines), care and research: tetanus, rabies, meningitis, neural tube defects, stroke, neurocysticercosis (parasitic infection that affects the central nervous system), encephalitis (inflammation of the brain), and neonatal encephalopathy (brain injury).

The study also examined 20 modifiable risk factors for potentially preventable neurological conditions such as stroke, dementia and idiopathic intellectual disability.

Eliminating key risk factors – most importantly, high systolic blood pressure and ambient and household air pollution – could prevent up to 84% of stroke DALYs. Similarly, preventing exposure to lead could reduce the burden of idiopathic intellectual disability by 63.1%, and reducing high fasting plasma glucose levels could reduce the burden of dementia by 14.6%. Smoking significantly contributed to stroke, dementia and multiple sclerosis risk.

More investments needed to improve treatment, care and quality of life

At the World Health Assembly in 2022, Member States adopted the Intersectoral global action plan on epilepsy and other neurological disorders 2022–2031 (IGAP) with an ambitious scope to address the long standing neglect of neurological disorders.

“The Intersectoral Global Action Plan 2022–2031 sets out a roadmap for countries to improve prevention, early identification, treatment and rehabilitation of neurological disorders. To achieve equity and access to quality care, we also need to invest in more research on risks to brain health, improved support for the healthcare workforce and adequate services,” said Dévora Kestel, Director, WHO Department of Mental Health and Substance Use.

IGAP sets out strategic objectives and targets to improve access to treatment, care and support for people with neurological disorders; implement strategies for brain health promotion and disease prevention; strengthen research and data; and emphasize a public health approach to epilepsy and other neurological disorders.

WHO report reveals gender inequalities at the root of global crisis in health and care work

WHO news - 12.03.2024

`A new report published by the World Health Organization (WHO), “Fair share for health and care: gender and the undervaluation of health and care work" illustrates how gender inequalities in health and care work negatively impact women, health systems and health outcomes.

The report outlines underinvestment in health systems results in a vicious cycle of unpaid health and care work, lowering women’s participation in paid labour markets, harming women’s economic empowerment and hampering gender equality.

Women comprise 67% of the paid global health and care workforce. In addition to this paid work, it has been estimated that women perform an estimated 76% of all unpaid care activities. Work that is done primarily by women tends to be paid less and have poor working conditions.

The report highlights that low pay and demanding working conditions are commonly found in the health and care sector. Devaluing caregiving, which is work performed primarily by women, negatively impacts wages, working conditions, productivity and the economic footprint of the sector.

The report illustrates that decades of chronic underinvestment in health and care work is contributing to a growing global crisis of care. With stagnation in progress towards universal health coverage (UHC), resulting in 4.5 billion people lacking full coverage of essential health services, women may take on even more unpaid care work. The deleterious impact of weak health systems combined with increasing unpaid health and care work are further straining the health of caregivers and the quality of services.

“The ‘Fair share’ report highlights how gender-equitable investments in health and care work would reset the value of health and care and drive fairer and more inclusive economies,” said Jim Campbell, WHO Director for Health Workforce. “We are calling upon leaders, policy-makers and employers to action investment: it is time for a fair share for health and care.”

The report presents policy levers to better value health and care work:

  1. Improve working conditions for all forms of health and care work, especially for highly feminised occupations
  2. Include women more equitably in the paid labour workforce
  3. Enhance conditions of work and wages in the health and care workforce and ensure equal pay for work of equal value
  4. Address the gender gap in care, support quality care work and uphold the rights and well-being of caregivers   
  5. Ensure that national statistics account for, measure and value all health and care work
  6. Invest in robust public health systems

Investments in health and care systems not only accelerate progress on UHC, they redistribute unpaid health and care work. When women participate in paid health and care employment, they are economically empowered and health outcomes are better. Health systems need to recognize, value and invest in all forms health and care work.

 

Global child deaths reach historic low in 2022 – UN report

WHO news - 12.03.2024
The number of children who died before their fifth birthday has reached a historic low, dropping to 4.9 million in 2022, according to the latest estimates released today by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME).
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