In 2010, the United States adopted its first-ever comprehensive set of health system reforms in the Affordable Care Act (ACA). Implementation of the law, though politically contentious and controversial, has now reached a stage where reversal of most elements of the law is no longer feasible. The controversial portions of the law that expand affordable health insurance coverage to most U.S. citizens and legal residents do not offer any important lessons for the global community. The portions of the law seeking to improve the quality, effectiveness, and efficiency of medical care as delivered in the U.S., hold lessons for the global community as all nations struggle to gain greater value from the societal resources they invest in medical care for their peoples. Health reform is an ongoing process of planning, legislating, implementing, and evaluating system changes. The U.S. set of delivery system reforms has much for reformers around the globe to assess and consider.

The grand challenge in global health is the inequality in mortality and life expectancy between countries and within countries. According to Global Health 2035, the Lancet Commission celebrating the 20th anniversary of the World Development Report (WDR) of 1993, the world now has the unique opportunity to achieve a grand convergence in global mortality within a generation. This article comments on the main findings and recommendations of the Global Health 2035.

Human-induced climate change, with such rapid and continuing global-scale warming, is historically unprecedented and signifies that human pressures on Earth’s life-supporting natural systems now exceed the planet’s bio-geo-capacity. The risks from climate change to health and survival in populations are diverse, as are the social and political ramifications. Although attributing observed health changes in a population to the recent climatic change is difficult, a coherent pattern of climate- and weather-associated changes is now evident in many regions of the world. The risks impinge unevenly, especially on poorer and vulnerable regions, and are amplified by pre-existing high rates of climate-sensitive diseases and conditions. If, as now appears likely, the world warms by 3-5oC by 2100, the health consequences, directly and via massive social and economic disruption, will be severe. The health sector has an important message to convey, comparing the health risks and benefits of enlightened action to avert climate change and to achieve sustainable ways of living versus the self-interested or complacent inaction.

The health sector, a foremost service sector in Nigeria, faces a number of challenges; primarily, the persistent under-funding of the health sector by the Nigerian government as evidence reveals low allocations to the health sector and poor health system performance which are reflected in key health indices of the country.Notwithstanding, there is evidence that the private sector could be a key player in delivering health services and impacting health outcomes, including those related to healthcare financing. This underscores the need to optimize the role of private sector in complementing the government’s commitment to financing healthcare delivery and strengthening the health system in Nigeria. There are also concerns about uneven quality and affordability of private-driven health systems, which necessitates reforms aimed at regulation. Accordingly, the argument is that the benefits of leveraging the private sector in complementing the national government in healthcare financing outweigh the challenges, particularly in light of lean public resources and finite donor supports. This article, therefore, highlights the potential for the Nigerian government to scale up healthcare financing by leveraging private resources, innovations and expertise, while working to achieve the universal health coverage.

Background Institut Pasteur International Network (IPIN), which includes 32 research institutes around the world, is a network of research and expertise to fight against infectious diseases. A scientometric approach was applied to describe research and collaboration activities of IPIN. Methods Publications were identified using a manual search of IPIN member addresses in Science Citation Index Expanded (SCIE) between 2006 and 2011. Total publications were then subcategorized by geographic regions. Several scientometric indicators and the H-index were employed to estimate the scientific production of each IPIN member. Subject and geographical overlay maps were also applied to visualize the network activities of the IPIN members. Results A total number of 12667 publications originated from IPIN members. Each author produced an average number of 2.18 papers and each publication received an average of 13.40 citations. European Pasteur Institutes had the largest amount of publications, authored papers, and H-index values. Biochemistry and molecular biology, microbiology, immunology and infectious diseases were the most important research topics, respectively. Geographic mapping of IPIN publications showed wide international collaboration among IPIN members around the world. Conclusion IPIN has strong ties with national and international authorities and organizations to investigate the current and future health issues. It is recommended to use scientometric and collaboration indicators as measures of research performance in IPIN future policies and investment decisions.

Background The pursuit of equity in health and healthcare has been the key feature of health policy in India. However, despite the policy significance, the volume of literature available on this issue is scarce. Therefore, this paper is an attempt to examine the horizontal inequities in healthcare utilization, consisting of outpatient and inpatient care in 15 major states and north-eastern region of India. Methods Cross-sectional data were taken from the National Sample Survey Organization (NSSO) 60th round (2004), the survey on ‘morbidity and healthcare’. While outpatient care was assessed using the probability of outpatient visit 15 days prior to the survey date, the indicators of inpatient care utilization were based on the following variables: the probability of hospital admission and length of stay in hospital over a 12-month period. All these measures of healthcare utilization were standardized for need differences and controlled for socio-economic factors. Need standardized concentration indices were used to measure interstate and intrastate income-related inequities in healthcare utilization. Results Absolute inequalities were found between states in the proportion of the population reporting a visit to an outpatient provider, in the range of 4.42% to 21.72%. Similarly, inpatient care varied from 1% to 10%. The magnitude of inequity for both outpatient and inpatient care was pro-rich across rural and urban areas of India and in majority of the states. In fact, in majority of the states, the horizontal inequity across types of curative care was noticeably higher within the rural population than in the urban population. The analysis demonstrated that high per capita government health spending was significantly associated with low inequity in utilization of inpatient care. Conclusion The study concludes that it would be necessary to address the prevailing inequities in healthcare by substantially scaling up the public spending on health, and achieving effective universal coverage of healthcare in India.

This paper reviews the essence of effective governance and importance of a multi-sectoral approach in generating health systems response to HIV/AIDS. This comprehensive approach highlights the importance of integrating reproductive sexual health programs and HIV prevention services, including peer education, life skills, and Voluntary Counseling and Testing (VCT), for Prevention of Mother–to-Child Transmission (PMTCT) and reaching out to People Living with HIV/AIDS (PLHA). Research implications for governance of health systems response to HIV/AIDS, integrated youth health policies and high-level political commitment, are emphasized by strategic implications for HIV/AIDS control and followed by a policy thrust on health systems as a strategic plan to achieve sustainability in the fight against HIV/AIDS.

In this commentary, the idea of closing the gap between knowing and doing through closing the gap between academics and practitioners is explored. The two communities approach to knowledge production and use, has predominated within healthcare, resulting in a separation between the worlds of research and practice, and, therefore, between its producers and users. Meaningful collaborations between the producers and users of research could in theory, create the conditions for more situated knowledge production and use, and result in a potential reduction in the evidence-practice divide within a health service context.

This is a short writing in response to the “Financial Incentives: Only One Piece of the Workplace Wellness Puzzle” (1) by Kristin Van Busum and Soeren Mattke of the RAND Health Advisory Services, RAND Corporation, in Boston. We would like to thank Kristin Van Busum and Soeren Mattke for their time in reading our article and offering excellent suggestions to employers and policymakers in order to make workplace wellness programs more successful for all employees. We agree that offering financial incentives is just one “piece of the puzzle” for employers as they contemplate strategies to effectively deal with this “giant elephant in the boardroom.” It is good to see that there is agreement on the urgent need for addressing chronic illnesses in the workplace along with reducing the spiraling healthcare costs.

In his response to our article (1,2), David Buchanan introduces some useful and important distinctions in the concepts of equality and autonomy. He highlights, for example, the distinction between inequality and inequity, which captures the insight that not all differences between people are unjust. Unjust inequalities are a subset of differences between people, and theories of justice can be defined by how they determine which of these differences are unjust. In addition, he points out that autonomy is not simply a matter of negative liberty, but also about a positive capacity to act. This understanding of autonomy is consistent with the account we offered in the paper, which underlines the importance of both the capacity to understand available options, and the capacity to act on the choices that one makes

Global Tuberculosis (TB) report (2013) has revealed that an estimated 8.6 million people developed TB of which, India accounts for almost 26% of the cases. These estimates clearly suggest that the country’s efforts to achieve Millennium Development Goal 6 by 2015 have not delivered the desired output. In India, the TB prevention and control activities are supervised and implemented under the Revised National TB Control Program (RNTCP), which recognizes that implementation of a good quality Directly Observed Treatment with Short course chemotherapy (DOTS) is the first priority for TB control. Directly Observed Treatment (DOT) is the key element in DOTS strategy, in which a DOT provider insures and supports the patients in consuming their drugs throughout the course of treatment. In order to meet the country’s vision to achieve universal access of TB care, the RNTCP has launched a “treatment adherence scheme” (public-private partnership scheme). Further, an evidence-based integrated strategy should be formulated for addressing the identified barriers which advocates universal administration of DOT. To conclude, DOT in RNTCP insures long-term adherence to the treatment, with right drugs in right doses, at right intervals and thus plays an indispensable role in improving the outcome indicators of the program and the quality of life in patients.

Economics has hit the mainstream in the last decade with popular books like Freakonomics and The Undercover Economist reaching the masses. These authors have used their toolkits far beyond the narrow scope of money and finance and answered questions pertaining to anything from social policy to demographics to crime. Their appeal has largely been their ability to explain that small underlying forces can have major impacts, intended or otherwise, on many different areas of society. One recent book following this trend is Nudge, published in 2008 by University of Chicago academics Richard Thaler and Cass Sunstein. The book has attracted acclaim from both journals and the press, with The Financial Times naming it as one of the best business books for 2008.