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  • A major development during was that

    2019-06-13

    A major development during 2015 was that OCV demand exceeded supply (). The main reasons for this increase in demand are the observed feasibility of mass OCV campaigns and their ability to confer protection to underserved populations in complex situations. The increased availability and use of OCV has a multifaceted added value. OCV and established cholera response measures (eg, water, sanitation, and hygiene [WASH] measures; treatment regimens; surveillance; and social mobilisation) have often been viewed in the past as competitive, if not mutually exclusive. With greater awareness and use of OCV, these measures and vaccines are now being considered as complimentary and have proven to be synergistic on many occasions. In this sense, the stockpile becomes an operational data generator. In other words, with emphasis on vaccine availability accompanying the use of OCV, many donors and partners have worked together within the framework of the Global Task Force on Cholera Control to show the public health potential of a coordinated effort against cholera. The growing body of evidence of vaccine effectiveness and costing data is contributing to inform large investments in integrated control and prevention strategies. Over recent years, countries have become more prepared to report cholera, which is an important and positive change from the past, in which political and economic imperatives prevailed.
    Women\'s health has gone through a major epidemiological transition in the past decades. It is now time to rethink how global health defines maternal in order to encompass challenges to the health of all women, as well as their transformative potential as productive members of society. The term refers, as generally defined, to life experiences that are not unique or restricted to pregnancy. Yet, the current global health use of maternal health concentrates attention to a narrow p-Cresyl sulfate of women\'s lives—pregnancy, childbirth, and 6 weeks\' post partum. While this definition of maternal health shows tremendous inequities affecting women, it is restricted by its exclusive focus on the . It does not consider the health of women who are not mothers, the many other problems that lead to premature death and disability, or the multiple roles women have in all societies. Furthermore, deaths associated with pregnancy, childbirth, and the postpartum period represent a decreasing fraction of women\'s overall burden of disease. The narrow focus on maternal health in relation to pregnancy and childbirth was appropriate historically. In low-income and middle-income countries (LMICs), the improvements in maternal deaths around childbirth were very modest during most of the 20th century, prompting a maternal and child health approach as a worldwide campaign to improve maternal health. These path-breaking initiatives successfully oriented work in global health for women—especially towards Millennium Development Goal 5. The most recent global estimates of the maternal mortality ratio show a decline from 385 per 100 000 live births in 1990 to 216 per 100 000 in 2015, with 303 000 maternal deaths in 2015. While estimates vary across sources, all coincide with a . These major reductions are largely due to improvements in countries of low income, but most preventable maternal deaths continue to happen to the world\'s poorest women. Simultaneously, women worldwide have experienced a rapidly growing burden of chronic and non-communicable diseases (NCDs). In 2013, among women aged 15–49 years, NCDs accounted for 44% of deaths and almost 65% of disability-adjusted life years compared with 7% of all deaths and 5% of all associated with maternal disorders. Cancers of the breast and cervix are now leading killers of this group of women in LMICs and deaths outnumber pregnancy-associated mortality in every developing region except in sub-Saharan Africa. In view of the remarkable transitions in the health needs and roles of women, a narrow conception of maternal health undervalues the burden of illness faced by women, because most women live past the age of child bearing. Narrow interpretations of maternal health adversely affect global health priorities, and can lead to a restrictive vision of the needs of women across their life cycle and restrict their potential to contribute to their families, communities, health systems, societies, and economies.