Cryptococcus is the most common cause of meningitis in adults living with HIV in sub-Saharan Africa. Global burden estimates are crucial to guide prevention strategies and to determine treatment needs, and we aimed to provide an updated estimate of global incidence of HIV-associated cryptococcal disease.
Investigators working both in syndemics, a field of applied health research with roots in medical anthropology, and in the field of health and human rights recognise that upstream social, political, and structural determinants contribute more to health inequities than do biological factors or personal choices. Syndemics investigates synergistic, often deleterious interactions among comorbid health conditions, especially under circumstances of structural and political adversity.
The co-occurrence of health burdens in transitioning populations, particularly in specific socioeconomic and cultural contexts, calls for conceptual frameworks to improve understanding of risk factors, so as to better design and implement prevention and intervention programmes to address comorbidities. The concept of a syndemic, developed by medical anthropologists, provides such a framework for preventing and treating comorbidities.
The syndemics model of health focuses on the biosocial complex, which consists of interacting, co-present, or sequential diseases and the social and environmental factors that promote and enhance the negative effects of disease interaction. This emergent approach to health conception and clinical practice reconfigures conventional historical understanding of diseases as distinct entities in nature, separate from other diseases and independent of the social contexts in which they are found.
How we think about disease pathologies affects how we design policies and deliver care to those most affected by social and economic inequities. Conventional frameworks in medicine and public health, such as comorbidity and multimorbidity, often overlook the effects of social, political, and ecological factors. The theory of syndemics improves on conventional frameworks in both theoretical and practical terms by illuminating how macro-level social factors promote disease clustering at the population level and impact disease pathologies at the individual level.
Sub-Saharan African populations and economies are growing at unprecedented speed with a population growth of 2.7% annually and economic growth of 4.4% annually.
Africa has the fastest-growing middle class in the world, with 313 million people (roughly the population of the US), 34% of Africa’s population. This growing middle class is demanding higher-quality and more specialized medical care from both the public and the private sector.
“Prisoners are among the most neglected of the key populations; they bear higher burdens of HIV, viral hepatitis and tuberculosis than in the communities from which they come,” said Professor Chris Beyrer of Johns Hopkins University and outgoing President of the International AIDS Society. He was speaking during a symposia dedicated to a special issue of The Lancet, published to coincide with the 21st International AIDS Conference (AIDS 2016) in Durban, South Africa, containing a comprehensive series of reviews on HIV and related infections in prisoners.
Open Now from Duke University: An introduction to key challenges and concepts important to understanding the current status and determinants of global health. This course is self-paced, with suggested deadlines to help you keep on track.