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      Changing the Discourse in Ambitions Towards Universal Health Coverage: Lessons From Australian Primary Healthcare Comment on "Universal Health Coverage for Non-communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

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          Abstract

          While Australia’s health system has reached universal health coverage (UHC), recent scholarship points to its strengths and identifies ways it could be more effective and equitable, especially for tackling non-communicable diseases (NCDs). Building on the Australian experience, we add to these perspectives and present pertinent lessons for the quest towards UHC, and for policy-makers globally with regard to NCDs. Potential lessons include: the need for ( i) vigilance – UHC requires ongoing monitoring and evaluation of not only financial risk protection but non-financial barriers and impacts such as forgone care; ( ii) investment and action now on structural determinants of NCDs and related inequalities to avoid potentially higher (fiscal, social and health) costs in the longer term; and ( iii) the opportunity for policy-makers globally and nationally to revisit their ambitions for UHC to include population health policies/ programs beyond essential health services that are required for healthier, more equitable and thriving societies.

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          Most cited references15

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          The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report

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            The impact of diabetes on tuberculosis treatment outcomes: A systematic review

            Background Multiple studies of tuberculosis treatment have indicated that patients with diabetes mellitus may experience poor outcomes. We performed a systematic review and meta-analysis to quantitatively summarize evidence for the impact of diabetes on tuberculosis outcomes. Methods We searched PubMed, EMBASE and the World Health Organization Regional Indexes from 1 January 1980 to 31 December 2010 and references of relevant articles for reports of observational studies that included people with diabetes treated for tuberculosis. We reviewed the full text of 742 papers and included 33 studies of which 9 reported culture conversion at two to three months, 12 reported the combined outcome of failure and death, 23 reported death, 4 reported death adjusted for age and other potential confounding factors, 5 reported relapse, and 4 reported drug resistant recurrent tuberculosis. Results Diabetes is associated with an increased risk of failure and death during tuberculosis treatment. Patients with diabetes have a risk ratio (RR) for the combined outcome of failure and death of 1.69 (95% CI, 1.36 to 2.12). The RR of death during tuberculosis treatment among the 23 unadjusted studies is 1.89 (95% CI, 1.52 to 2.36), and this increased to an effect estimate of 4.95 (95% CI, 2.69 to 9.10) among the 4 studies that adjusted for age and other potential confounding factors. Diabetes is also associated with an increased risk of relapse (RR, 3.89; 95% CI, 2.43 to 6.23). We did not find evidence for an increased risk of tuberculosis recurrence with drug resistant strains among people with diabetes. The studies assessing sputum culture conversion after two to three months of tuberculosis therapy were heterogeneous with relative risks that ranged from 0.79 to 3.25. Conclusions Diabetes increases the risk of failure and death combined, death, and relapse among patients with tuberculosis. This study highlights a need for increased attention to treatment of tuberculosis in people with diabetes, which may include testing for suspected diabetes, improved glucose control, and increased clinical and therapeutic monitoring.
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              Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco

              In an article that forms part of the PLoS Medicine series on Big Food, David Stuckler and colleagues report that unhealthy packaged foods are being consumed rapidly in low- and middle-income countries, consistent with rapid expansion of multinational food companies into emerging markets and fueling obesity and chronic disease epidemics.
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                Author and article information

                Journal
                Int J Health Policy Manag
                Int J Health Policy Manag
                Kerman University of Medical Sciences
                International Journal of Health Policy and Management
                Kerman University of Medical Sciences
                2322-5939
                June 2022
                01 December 2021
                : 11
                : 6
                : 851-854
                Affiliations
                1Independent Consultant, Lyon, France.
                2The University of New South Wales, Sydney, NSW, Australia.
                3Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany.
                4Section for Health Equity Studies & Migration, Heidelberg University Hospital, Heidelberg, Germany.
                Author notes
                [* ]Correspondence to: Sarah J. Simpson Email: sarah.simpson@ 123456equiact.net
                Author information
                https://orcid.org/0000-0003-1896-5145
                https://orcid.org/0000-0003-4663-1716
                https://orcid.org/0000-0002-1411-1209
                Article
                10.34172/ijhpm.2021.165
                9309900
                34973056
                2abf1601-c123-4704-87d0-c7ebd01b5b60
                © 2022 The Author(s); Published by Kerman University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 July 2021
                : 30 November 2021
                Page count
                References: 29, Pages: 4
                Categories
                Commentary

                australia,equity,non-communicable diseases,financial risk protection,universal health coverage,structural determinants

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