Partnership with private sector only way to tackle waiting lists properly
Government plans for five to ten years ahead tend to be affected by deep discounting and great uncertainty about future funding. Even a prime ministerial assurance may not be worth much against the global market place. Long term plans have their place, but should be thought of as a process with a series of steps. The key question is about the first phase: can we get momentum going in making a real difference to the problem?
Consuming health care
Another year winds itself up like a scroll. As the final few days stretch out before the festive season, managers throughout the country will be hoping that the seasonal flu remains as it is at present: mainly of the least virulent strain. The prayer must be that, if not ‘the season to be jolly’, this winter will not be the cause of misery for patients and for all the team of staff throughout the health service.
Complexities of Assessing the Disease Burden Attributable to Leishmaniasis
Among parasitic diseases, morbidity and mortality caused by leishmaniasis are surpassed only by malaria and lymphatic filariasis. However, estimation of the leishmaniasis disease burden is challenging, due to clinical and epidemiological diversity, marked geographic clustering, and lack of reliable data on incidence, duration, and impact of the various disease syndromes. Non-health effects such as impoverishment, disfigurement, and stigma add to the burden, and introduce further complexities. Leishmaniasis occurs globally, but has disproportionate impact in the Horn of Africa, South Asia and Brazil (for visceral leishmaniasis), and Latin America, Central Asia, and southwestern Asia (for cutaneous leishmaniasis). Disease characteristics and challenges for control are reviewed for each of these foci. We recommend review of reliable secondary data sources and collection of baseline active survey data to improve current disease burden estimates, plus the improvement or establishment of effective surveillance systems to monitor the impact of control efforts.