Prevention, Policy, and Public Health provides a basic foundation for students, professionals, and researchers to be more effective in the policy arena. It offers information on the dynamics of the policymaking process, theoretical frameworks, analysis, and policy applications. It also offers coverage of advocacy and communication, the two most integral aspects of shaping policies for public health.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
Increased HIV screening may help identify more people with the disease, but there may not be enough resources to provide them with the care they need. The Institute of Medicine's Committee on HIV Screening and Access to Care concludes that more practitioners must be trained in HIV/AIDS care and treatment and their hospitals, clinics, and health departments must receive sufficient funding to meet a growing demand for care.
Since 2004, the U.S. government has supported the global response to HIV/AIDS through the President's Emergency Plan for AIDS Relief (PEPFAR). The Republic of Rwanda, a PEPFAR partner country since the initiative began, has made gains in its HIV response, including increased access to and coverage of antiretroviral therapy and decreased HIV prevalence. However, a persistent shortage in human resources for health (HRH) affects the health of people living with HIV and the entire Rwandan population. Recognizing HRH capabilities as a foundational challenge for the health system and the response to HIV, the Government of Rwanda worked with PEPFAR and other partners to develop a program to strengthen institutional capacity in health professional education and thereby increase the production of high-quality health workers. The Program was fully managed by the Government of Rwanda and was designed to run from 2011 through 2019. PEPFAR initiated funding in 2012. In 2015, PEPFAR adopted a new strategy focused on high-burden geographic areas and key populations, resulting in a reconfiguration of its HIV portfolio in Rwanda and a decision to cease funding the Program, which was determined no longer core to its programming strategy. The last disbursement for the Program from PEPFAR was in 2017. Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program describes PEPFAR-supported HRH activities in Rwanda in relation to programmatic priorities, outputs, and outcomes and examines, to the extent feasible, the impact on HRH and HIV-related outcomes. The HRH Program more than tripled the country's physician specialist workforce and produced major increases in the numbers and qualifications of nurses and midwives. Partnerships between U.S. institutions and the University of Rwanda introduced new programs, upgraded curricula, and improved the quality of teaching and training for health professionals. Growing the number, skills, and competencies of health workers contributed to direct and indirect improvements in the quality of HIV care. Based on the successes and challenges of the HRH program, the report recommends that future investments in health professional education be designed within a more comprehensive approach to human resources for health and institutional capacity building, which would strengthen the health system to meet both HIV-specific and more general health needs. The recommendations offer an aspirational framework to reimagine how partnerships are formed, how investments are made, and how the effects of those investments are documented.
One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
The growing number of older adults in the United States poses a significant challenge to families, healthcare systems, mental health services, and many other caregiving groups. Using the Grand Challenges for Social Work initiative as a framework, this text evaluates critical policies and issues pertaining to older adults, identifying both the overall systemic inequalities currently working against older adults as well as specific areas that require updated policies and interventions. It calls for active attention to the implementation of science-based research, policy, and practices to promote health and well-being. Among the topics addressed: Family violence against older adults Disaster planning and preparedness Building financial capability for aging families Health needs of incarcerated older adults Closing the gap in healthcare services for older adults Social isolation and its effects on mental health and well-being A useful gerontology resource for students, social work scholars, and practitioners, Gerontological Social Work and the Grand Challenges advocates for justice and equal opportunity for older adults, and highlights important social issues that must be urgently addressed in the near future.
Biomedical Advances in HIV Prevention: Social and Behavioral Perspectives Lisa A. Eaton and Seth C. Kalichman, editors Three decades into the epidemic, a great deal is known about HIV and its transmission, more people are living with the disease, and the virus is no longer seen as a death sentence. But new people continue to be infected with HIV each year, making prevention strategies that are medically effective and behaviorally engaging as urgent a priority as ever. Biomedical Advances in HIV Prevention: Social and Behavioral Perspectives assembles the latest improvements, barriers to implementation, and possibilities for--and challenges to--future progress. Innovations such as pre-exposure prophylaxis (antiretroviral regimens for the high-risk uninfected) and treatment as prevention (early use of ART to reduce infectiousness of new patients) are examined, as are current findings on ongoing prevention and treatment concerns. Contributors illuminate the complex realities entailing adherence, pointing out technological, behavioral, and cultural roadblocks as well as opportunities to significantly reduce infection rates. Detailed up-to-the-minute coverage includes: Prevention services for persons living with HIV Adherence to HIV treatment as prevention and pre-exposure prophylaxis Advocating for rectal microbicides and safe lubricants Mental health and substance use in the scale-up of HIV prevention Risk compensation in response to HIV prevention Implementing biomedical HIV prevention advances: reports from South Africa, Uganda, Australia, Thailand, United States, Ecuador, and Peru Researchers, practitioners, and policy makers working in the fields of HIV/AIDS and public health will look toward Biomedical Advances in HIV Prevention: Social and Behavioral Perspectives as both a means for developing and assessing current programs and a blueprint for the next generation of prevention efforts.
