Suchergebnisse

Prologue: Steady hands needed for turbulent times -- the DFAT secretaries 1979-99a --Peter Henderson, AC --Stuart Harris, AO --Richard Woolcott, AC --Michael Costello, AO --Philip Flood, AO --Epilogue: 'The job is never done' --Appendix 1:Data on DFAT staff numbers and budget allocations.

In this monograph, five former secretaries of the Department of Foreign Affairs and Trade (DFAT) reflect on their experiences and the challenges of their times. A far cry from the pukka fantasies of 'Yes Minister', their recollections reveal the realpolitik of the policy front line where the secretary must stay ahead of emerging themes and issues in Australia's international relations while simultaneously exercising governance oversight and providing leadership to a large, professional, diverse and dispersed organisation. From the Cold War to the War on Terror; from the floating of the dollar to GATT and the WTO; managing relations big and small, within our region and without; through relentless administrative reforms, technological change and changes of government; steering DFAT requires 'steady hands'. This collection of public lectures presented in 2006 to the Australian Institute of International Affairs (AIIA) offers an invaluable resource for those with an interest in recent Australian history, foreign policy and public sector administration

In this monograph, five former secretaries of the Department of Foreign Affairs and Trade (DFAT) reflect on their experiences and the challenges of their times. A far cry from the pukka fantasies of 'Yes Minister', their recollections reveal the realpolitik of the policy front line where the secretary must stay ahead of emerging themes and issues in Australia's international relations while simultaneously exercising governance oversight and providing leadership to a large, professional, diverse and dispersed organisation. From the Cold War to the War on Terror; from the floating of the dollar to GATT and the WTO; managing relations big and small, within our region and without; through relentless administrative reforms, technological change and changes of government; steering DFAT requires 'steady hands'. This collection of public lectures presented in 2006 to the Australian Institute of International Affairs (AIIA) offers an invaluable resource for those with an interest in recent Australian history, foreign policy and public sector administration

IntroductionPoint‐of‐care testing for CD4 cell count is considered a promising way of reducing the time to eligibility assessment for antiretroviral therapy (ART) and of increasing retention in care prior to treatment initiation. In this review, we assess the available evidence on the patient and programme impact of point‐of‐care CD4 testing.MethodsWe searched nine databases and two conference sites (up until 26 October 2013) for studies reporting patient and programme outcomes following the introduction of point‐of‐care CD4 testing. Where appropriate, results were pooled using random‐effects methods.ResultsFifteen studies, mainly from sub‐Saharan Africa, were included for review, providing evidence for adults, adolescents, children and pregnant women. Compared to conventional laboratory‐based testing, point‐of‐care CD4 testing increased the likelihood of having CD4 measured [odds ratio (OR) 4.1, 95% CI 3.5–4.9, n=2] and receiving a CD4 result (OR 2.8, 95% CI 1.5–5.6, n=6). Time to being tested was significantly reduced, by a median of nine days; time from CD4 testing to receiving the result was reduced by as much as 17 days. Evidence for increased treatment initiation was mixed.DiscussionThe results of this review suggest that point‐of‐care CD4 testing can increase retention in care prior to starting treatment and can also reduce time to eligibility assessment, which may result in more eligible patients being initiated on ART.

OBJECTIVES: Examining the availability of essential medicines is a necessary step to monitor country-level progress towards universal health coverage. We compared the 2017 essential medicine lists (EML) of 137 countries to the WHO Model List to assess differences by drug class and country setting. METHODS: We extracted all medicines prioritised at country level from most recently available national EMLs and compared each national EML with the 2017 WHO Model List of Essential Medicines (MLEM) as the reference standard. We assess EMLs by WHO region and for different types of medicine subgroups (eg, cancer, anti-infectives, cardiac, psychiatric and anaesthesia medicines) using within second-level anatomical therapeutic class (ATC) drug classes of the ATC Index. RESULTS: We included 406 medicines from WHO's 2017 MLEM to compare to 137 concurrent national EMLs. We found a median of 315 (range from 44 to 983) medicines listed on national EMLs. The global median F1 score was 0.59 (IQR 0.47–0.70, maximum possible score indicating alignment with MLEM is 1). The F1 score was the highest (ie, most similar to MLEM) in the South-East Asia region and the lowest in the European region (ie, most dissimilar to MLEM). The F1 score was highest for stomatological preparations (median: 1.00), gynaecological—anti-infectives and antiseptics (median: 1.00), and medicated dressings (median: 1.00), and lowest for 9 anatomical or pharmacological groups (median: 0.00, eg, treatments for bone diseases, digestive enzymes). CONCLUSIONS: Most countries are expected to improve their national health coverage by 2030 offering access to essential medicines, but our results revealed substantial gaps in selection of medicines at the national level compared with those recommended by WHO. It is crucial that governments consider investing in those effective medicines that are now neglected and continue monitoring progress towards essential medicine access as part of universal health coverage.

Cascade-of-care (CoC) monitoring is an important component of the response to the global hepatitis C virus (HCV) epidemic. CoC metrics can be used to communicate, in simple terms, the extent to which national and subnational governments are advancing on key targets, and CoC findings can inform strategic decision-making regarding how to maximize the progression of individuals with HCV to diagnosis, treatment, and cure. The value of reporting would be enhanced if a standardized approach were used for generating CoCs. We have described the Consensus HCV CoC that we developed to address this need and have presented findings from Denmark, Norway, and Sweden, where it was piloted. We encourage the uptake of the Consensus HCV CoC as a global instrument for facilitating clear and consistent reporting via the World Health Organization (WHO) viral hepatitis monitoring platform and for ensuring accurate monitoring of progress toward WHO's 2030 hepatitis C elimination targets.

Cascade-of-care (CoC) monitoring is an important component of the response to the global hepatitis C virus (HCV) epidemic. CoC metrics can be used to communicate in simple terms the extent to which national and subnational governments are advancing on key targets, and CoC findings can inform strategic decision-making regarding how to maximize the progression of HCV-infected individuals to diagnosis, treatment and cure. The value of reporting would be enhanced if reporting entities utilized a standardized approach for generating their CoCs. We have described the Consensus HCV CoC that we developed to address this need and have presented findings from Denmark, Norway and Sweden, where it was piloted. We encourage the uptake of the Consensus HCV CoC as a global instrument for facilitating clear and consistent reporting via the World Health Organization (WHO) viral hepatitis monitoring platform and ensuring the accurate monitoring of progress toward WHO's 2030 hepatitis C elimination targets