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Sachs JD, Karim SSA, Aknin L, Allen J, Brosbøl K, Colombo F, Barron GC, Espinosa MF, Gaspar V, Gaviria A, Haines A, Hotez PJ, Koundouri P, Bascuñán FL, Lee JK, Pate MA, Ramos G, Reddy KS, Serageldin I, Thwaites J, Vike-Freiberga V, Wang C, Were MK, Xue L, Bahadur C, Bottazzi ME, Bullen C, Laryea-Adjei G, Ben Amor Y, Karadag O, Lafortune G, Torres E, Barredo L, Bartels JGE, Joshi N, Hellard M, Huynh UK, Khandelwal S, Lazarus JV, Michie S. The Lancet Commission on lessons for the future from the COVID-19 pandemic. Lancet 2022; 400:1224-1280. [PMID: 36115368 PMCID: PMC9539542 DOI: 10.1016/s0140-6736(22)01585-9] [Citation(s) in RCA: 202] [Impact Index Per Article: 101.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/01/2022] [Accepted: 08/11/2022] [Indexed: 02/03/2023]
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Jung M, Arnell A, de Lamo X, García-Rangel S, Lewis M, Mark J, Merow C, Miles L, Ondo I, Pironon S, Ravilious C, Rivers M, Schepaschenko D, Tallowin O, van Soesbergen A, Govaerts R, Boyle BL, Enquist BJ, Feng X, Gallagher R, Maitner B, Meiri S, Mulligan M, Ofer G, Roll U, Hanson JO, Jetz W, Di Marco M, McGowan J, Rinnan DS, Sachs JD, Lesiv M, Adams VM, Andrew SC, Burger JR, Hannah L, Marquet PA, McCarthy JK, Morueta-Holme N, Newman EA, Park DS, Roehrdanz PR, Svenning JC, Violle C, Wieringa JJ, Wynne G, Fritz S, Strassburg BBN, Obersteiner M, Kapos V, Burgess N, Schmidt-Traub G, Visconti P. Areas of global importance for conserving terrestrial biodiversity, carbon and water. Nat Ecol Evol 2021; 5:1499-1509. [PMID: 34429536 DOI: 10.1038/s41559-021-01528-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/07/2021] [Indexed: 02/07/2023]
Abstract
To meet the ambitious objectives of biodiversity and climate conventions, the international community requires clarity on how these objectives can be operationalized spatially and how multiple targets can be pursued concurrently. To support goal setting and the implementation of international strategies and action plans, spatial guidance is needed to identify which land areas have the potential to generate the greatest synergies between conserving biodiversity and nature's contributions to people. Here we present results from a joint optimization that minimizes the number of threatened species, maximizes carbon retention and water quality regulation, and ranks terrestrial conservation priorities globally. We found that selecting the top-ranked 30% and 50% of terrestrial land area would conserve respectively 60.7% and 85.3% of the estimated total carbon stock and 66% and 89.8% of all clean water, in addition to meeting conservation targets for 57.9% and 79% of all species considered. Our data and prioritization further suggest that adequately conserving all species considered (vertebrates and plants) would require giving conservation attention to ~70% of the terrestrial land surface. If priority was given to biodiversity only, managing 30% of optimally located land area for conservation may be sufficient to meet conservation targets for 81.3% of the terrestrial plant and vertebrate species considered. Our results provide a global assessment of where land could be optimally managed for conservation. We discuss how such a spatial prioritization framework can support the implementation of the biodiversity and climate conventions.
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Bromage S, Zhang Y, Holmes MD, Sachs SE, Fanzo J, Remans R, Sachs JD, Batis C, Bhupathiraju SN, Fung TT, Li Y, Stampfer MJ, Deitchler M, Willett WC, Fawzi WW. The Global Diet Quality Score Is Inversely Associated with Nutrient Inadequacy, Low Midupper Arm Circumference, and Anemia in Rural Adults in Ten Sub-Saharan African Countries. J Nutr 2021; 151:119S-129S. [PMID: 34689197 PMCID: PMC8542095 DOI: 10.1093/jn/nxab161] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/20/2021] [Accepted: 04/29/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Key nutrient deficits remain widespread throughout sub-Saharan Africa (SSA) whereas noncommunicable diseases (NCDs) now cause one-third of deaths. Easy-to-use metrics are needed to track contributions of diet quality to this double burden. OBJECTIVES We evaluated comparative performance of a novel food-based Global Diet Quality Score (GDQS) against other diet metrics in capturing nutrient adequacy and undernutrition in rural SSA adults. METHODS We scored the GDQS, Minimum Dietary Diversity-Women (MDD-W), and Alternative Healthy Eating Index-2010 (AHEI-2010) using FFQ data from rural men and nonpregnant, nonlactating women of reproductive age (15-49 y) in 10 SSA countries. We evaluated Spearman correlations between metrics and energy-adjusted nutrient intakes, and age-adjusted associations with BMI, midupper arm circumference (MUAC), and hemoglobin in regression models. RESULTS Correlations between the GDQS and an energy-adjusted aggregate measure of dietary protein, fiber, calcium, iron, zinc, vitamin A, folate, and vitamin B-12 adequacy were 0.34 (95% CI: 0.30, 0.38) in men and 0.37 (95% CI: 0.32, 0.41) in women. The GDQS was associated (P < 0.05) with lower odds of low MUAC [GDQS quintile (Q) 5 compared with Q1 OR in men: 0.44, 95% CI: 0.22, 0.85; women: 0.57, 95% CI: 0.31, 1.03] and anemia (Q5/Q1 OR in men: 0.56, 95% CI: 0.32, 0.98; women: 0.60, 95% CI: 0.35, 1.01). The MDD-W correlated better with some nutrient intakes, though associated marginally with low MUAC in men (P = 0.07). The AHEI-2010 correlated better with fatty acid intakes, though associated marginally with low MUAC (P = 0.06) and anemia (P = 0.14) in women. Overweight/obesity prevalence was low, and neither the GDQS, MDD-W, nor AHEI-2010 were predictive. CONCLUSIONS The GDQS performed comparably with the MDD-W in capturing nutrient adequacy-related outcomes in rural SSA. Given limited data on NCD outcomes and the cross-sectional study design, prospective studies are warranted to assess GDQS performance in capturing NCD outcomes in SSA.
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Jung M, Arnell A, de Lamo X, García-Rangel S, Lewis M, Mark J, Merow C, Miles L, Ondo I, Pironon S, Ravilious C, Rivers M, Schepaschenko D, Tallowin O, van Soesbergen A, Govaerts R, Boyle BL, Enquist BJ, Feng X, Gallagher R, Maitner B, Meiri S, Mulligan M, Ofer G, Roll U, Hanson JO, Jetz W, Di Marco M, McGowan J, Rinnan DS, Sachs JD, Lesiv M, Adams VM, Andrew SC, Burger JR, Hannah L, Marquet PA, McCarthy JK, Morueta-Holme N, Newman EA, Park DS, Roehrdanz PR, Svenning JC, Violle C, Wieringa JJ, Wynne G, Fritz S, Strassburg BBN, Obersteiner M, Kapos V, Burgess N, Schmidt-Traub G, Visconti P. Author Correction: Areas of global importance for conserving terrestrial biodiversity, carbon and water. Nat Ecol Evol 2021; 5:1557. [PMID: 34556831 DOI: 10.1038/s41559-021-01569-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sachs JD, Sachs LE. Business alignment for the “Decade of Action”. JOURNAL OF INTERNATIONAL BUSINESS POLICY 2021; 4:22-27. [PMCID: PMC7883887 DOI: 10.1057/s42214-020-00090-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/14/2020] [Accepted: 12/19/2020] [Indexed: 05/24/2023]
Abstract
The SDGs and Paris Climate Agreement, taken together, constitute the best hope for charting a new course for the world’s politics and economics, to produce “the future we want.” This paper briefly explores the central environmental, social, and economic challenges; the pathways to sustainability; and the central role of companies in achieving our global goals. We are facing four very deep and interconnected global environmental crises: human-induced climate change, unsustainable land use, mega-pollution, and increased frequency and intensity of pandemic zoonotic diseases. At the same time, we face massive social crises, including increasing inequality. There are six necessary SDG Transformations that each requires a major change in the organization of societal, political, and economic activities – which delineates also the critical role of business. The paper specifies four key questions that companies and their stakeholders can ask to effectively align with the "Decade of Action" needed to achieve the SDG ambitions.
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De Neve JE, Sachs JD. The SDGs and human well-being: a global analysis of synergies, trade-offs, and regional differences. Sci Rep 2020; 10:15113. [PMID: 32934290 PMCID: PMC7492223 DOI: 10.1038/s41598-020-71916-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/21/2020] [Indexed: 11/09/2022] Open
Abstract
This paper explores the empirical links between achieving the Sustainable Development Goals (SDGs) and subjective well-being. Globally, we find that in terms of well-being, there are increasing marginal returns to sustainable development. Unpacking the SDGs by looking at how each SDG relates to well-being shows, in most cases, a strong positive correlation. However, SDG12 (responsible production and consumption) and SDG13 (climate action) are negatively correlated with well-being. This suggests that in the short run there may be certain trade-offs to sustainable development, and further heterogeneity is revealed through an analysis of how these relationships play out by region. Variance decomposition methods also suggest large differences in how each SDG contributes to explaining the variance in well-being between countries. These and other empirical insights highlight that more complex and contextualized policy efforts are needed in order to achieve sustainable development while optimising for well-being.
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Sachs JD, Horton R, Bagenal J, Ben Amor Y, Karadag Caman O, Lafortune G. The Lancet COVID-19 Commission. Lancet 2020; 396:454-455. [PMID: 32653081 PMCID: PMC7347338 DOI: 10.1016/s0140-6736(20)31494-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 06/29/2020] [Indexed: 01/13/2023]
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Moghadas SM, Shoukat A, Fitzpatrick MC, Wells CR, Sah P, Pandey A, Sachs JD, Wang Z, Meyers LA, Singer BH, Galvani AP. Projecting hospital utilization during the COVID-19 outbreaks in the United States. Proc Natl Acad Sci U S A 2020; 117:9122-9126. [PMID: 32245814 PMCID: PMC7183199 DOI: 10.1073/pnas.2004064117] [Citation(s) in RCA: 304] [Impact Index Per Article: 76.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In the wake of community coronavirus disease 2019 (COVID-19) transmission in the United States, there is a growing public health concern regarding the adequacy of resources to treat infected cases. Hospital beds, intensive care units (ICUs), and ventilators are vital for the treatment of patients with severe illness. To project the timing of the outbreak peak and the number of ICU beds required at peak, we simulated a COVID-19 outbreak parameterized with the US population demographics. In scenario analyses, we varied the delay from symptom onset to self-isolation, the proportion of symptomatic individuals practicing self-isolation, and the basic reproduction number R0 Without self-isolation, when R0 = 2.5, treatment of critically ill individuals at the outbreak peak would require 3.8 times more ICU beds than exist in the United States. Self-isolation by 20% of cases 24 h after symptom onset would delay and flatten the outbreak trajectory, reducing the number of ICU beds needed at the peak by 48.4% (interquartile range 46.4-50.3%), although still exceeding existing capacity. When R0 = 2, twice as many ICU beds would be required at the peak of outbreak in the absence of self-isolation. In this scenario, the proportional impact of self-isolation within 24 h on reducing the peak number of ICU beds is substantially higher at 73.5% (interquartile range 71.4-75.3%). Our estimates underscore the inadequacy of critical care capacity to handle the burgeoning outbreak. Policies that encourage self-isolation, such as paid sick leave, may delay the epidemic peak, giving a window of time that could facilitate emergency mobilization to expand hospital capacity.
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Sachs JD. The urgent case for expanded development assistance for health. Int Health 2019; 11:321-323. [PMID: 31529115 DOI: 10.1093/inthealth/ihz059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/05/2019] [Accepted: 08/05/2019] [Indexed: 11/12/2022] Open
Abstract
The low-income developing countries require increased development assistance for health (DAH) to achieve Sustainable Development Goal 3, 'Healthy Lives for All'. DAH has a proven track record. DAH expanded during 2001-2008, with significant health gains in the LIDCs, but then stopped expanding in the wake of the 2008 financial crisis. The Global Fund to Fight AIDS, TB and Malaria requires around US$31.8 billion during 2021-2023 to maintain a trajectory to end the three epidemics by 2030, yet donors have so far signaled that they are prepared to offer less than half that sum, around US$14 billion.
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Hotez PJ, Biritwum NK, Fenwick A, Molyneux DH, Sachs JD. Ghana: Accelerating neglected tropical disease control in a setting of economic development. PLoS Negl Trop Dis 2019; 13:e0007005. [PMID: 30653493 PMCID: PMC6336233 DOI: 10.1371/journal.pntd.0007005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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McArthur JW, Sachs JD. Agriculture, Aid, and Economic Growth in Africa. THE WORLD BANK ECONOMIC REVIEW 2018; 33:1-20. [PMID: 33551535 PMCID: PMC7797631 DOI: 10.1093/wber/lhx029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
How can foreign aid to agriculture support economic growth in Africa? This paper constructs a geographically indexed applied general equilibrium model that considers pathways through which aid might affect growth and structural transformation of labor markets in the context of soil nutrient variation, minimum subsistence consumption requirements, domestic transport costs, labor mobility, and constraints to self-financing of agricultural inputs.Using plausible parameters, the model is presented for Uganda as an illustrative case.We present three stylized scenarios to demonstrate the potential economy-wide impacts of both soil nutrient loss and replenishment, and how foreign aid can be targeted to support agricultural inputs that boost rural productivity and shift labor to boost real wages. One simulation shows how a temporary program of targeted official development assistance (ODA) for agriculture could generate, contrary to traditional Dutch disease concerns, an expansion in the primary tradable sector and positive permanent productivity and welfare effects, leading to a steady decline in the need for complementary ODA for budget support.
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Mitchell S, Gelman A, Ross R, Chen J, Bari S, Huynh UK, Harris MW, Sachs SE, Stuart EA, Feller A, Makela S, Zaslavsky AM, McClellan L, Ohemeng-Dapaah S, Namakula P, Palm CA, Sachs JD. The Millennium Villages Project: a retrospective, observational, endline evaluation. LANCET GLOBAL HEALTH 2018; 6:e500-e513. [PMID: 29653625 DOI: 10.1016/s2214-109x(18)30065-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 02/09/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Millennium Villages Project (MVP) was a 10 year, multisector, rural development project, initiated in 2005, operating across ten sites in ten sub-Saharan African countries to achieve the Millennium Development Goals (MDGs). In this study, we aimed to estimate the project's impact, target attainment, and on-site spending. METHODS In this endline evaluation of the MVP, we retrospectively selected comparison villages that best matched the project villages on possible confounding variables. Cross-sectional survey data on 40 outcomes of interest were collected from both the project and the comparison villages in 2015. Using these data, as well as on-site spending data collected during the project, we estimated project impacts as differences in outcomes between the project and comparison villages; target attainment as differences between project outcomes and prespecified targets; and on-site spending as expenditures reported by communities, donors, governments, and the project. Spending data were not collected in the comparison villages. FINDINGS Averaged across the ten project sites, we found that impact estimates for 30 of 40 outcomes were significant (95% uncertainty intervals [UIs] for these outcomes excluded zero) and favoured the project villages. In particular, substantial effects were seen in agriculture and health, in which some outcomes were roughly one SD better in the project villages than in the comparison villages. The project was estimated to have no significant impact on the consumption-based measures of poverty, but a significant favourable impact on an index of asset ownership. Impacts on nutrition and education outcomes were often inconclusive (95% UIs included zero). Averaging across outcomes within categories, the project had significant favourable impacts on agriculture, nutrition, education, child health, maternal health, HIV and malaria, and water and sanitation. A third of the targets were met in the project sites. Total on-site spending decreased from US$132 per person in the first half of the project (of which $66 was from the MVP) to $109 per person in the second half of the project (of which $25 was from the MVP). INTERPRETATION The MVP had favourable impacts on outcomes in all MDG areas, consistent with an integrated rural development approach. The greatest effects were in agriculture and health, suggesting support for the project's emphasis on agriculture and health systems strengthening. The project conclusively met one third of its targets. FUNDING The Open Society Foundations, the Islamic Development Bank, and the governments of Japan, South Korea, Mali, Senegal, and Uganda.
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McCord GC, Conley D, Sachs JD. Malaria ecology, child mortality & fertility. ECONOMICS AND HUMAN BIOLOGY 2017; 24:1-17. [PMID: 27838563 PMCID: PMC6124668 DOI: 10.1016/j.ehb.2016.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 10/11/2016] [Accepted: 10/30/2016] [Indexed: 05/22/2023]
Abstract
The broad determinants of fertility are thought to be reasonably well identified by demographers, though the detailed quantitative drivers of fertility levels and changes are less well understood. This paper uses a novel ecological index of malaria transmission to study the effect of child mortality on fertility. We find that temporal variation in the ecology of the disease is well-correlated to mortality, and pernicious malaria conditions lead to higher fertility rates. We then argue that most of this effect occurs through child mortality, and estimate the effect of child mortality changes on fertility. Our findings add to the literature on disease and fertility, and contribute to the suggestive evidence that child mortality reductions have a causal effect on fertility changes.
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Sachs JD. High US Child Poverty: Explanations and Solutions. Acad Pediatr 2016; 16:S8-S12. [PMID: 27044707 DOI: 10.1016/j.acap.2016.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 02/08/2016] [Indexed: 10/22/2022]
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Sachs JD, Leeder SR. The G20, human health and sustainability: an interview with Jeffrey D Sachs. Med J Aust 2014; 201:253-4. [DOI: 10.5694/mja14.01075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 07/30/2014] [Indexed: 11/17/2022]
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Pronyk PM, Muniz M, Nemser B, Somers MA, McClellan L, Palm CA, Huynh UK, Ben Amor Y, Begashaw B, McArthur JW, Niang A, Sachs SE, Singh P, Teklehaimanot A, Sachs JD. The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment. Lancet 2012; 379:2179-88. [PMID: 22572602 DOI: 10.1016/s0140-6736(12)60207-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Simultaneously addressing multiple Millennium Development Goals (MDGs) has the potential to complement essential health interventions to accelerate gains in child survival. The Millennium Villages project is an integrated multisector approach to rural development operating across diverse sub-Saharan African sites. Our aim was to assess the effects of the project on MDG-related outcomes including child mortality 3 years after implementation and compare these changes to local comparison data. METHODS Village sites averaging 35,000 people were selected from rural areas across diverse agroecological zones with high baseline levels of poverty and undernutrition. Starting in 2006, simultaneous investments were made in agriculture, the environment, business development, education, infrastructure, and health in partnership with communities and local governments at an annual projected cost of US$120 per person. We assessed MDG-related progress by monitoring changes 3 years after implementation across Millenium Village sites in nine countries. The primary outcome was the mortality rate of children younger than 5 years of age. To assess plausibility and attribution, we compared changes to reference data gathered from matched randomly selected comparison sites for the mortality rate of children younger than 5 years of age. Analyses were done on a per-protocol basis. This trial is registered with ClinicalTrials.gov, number NCT01125618. FINDINGS Baseline levels of MDG-related spending averaged $27 per head, increasing to $116 by year 3 of which $25 was spent on health. After 3 years, reductions in poverty, food insecurity, stunting, and malaria parasitaemia were reported across nine Millennium Village sites. Access to improved water and sanitation increased, along with coverage for many maternal-child health interventions. Mortality rates in children younger than 5 years of age decreased by 22% in Millennium Village sites relative to baseline (absolute decrease 25 deaths per 1000 livebirths, p=0·015) and 32% relative to matched comparison sites (30 deaths per 1000 livebirths, p=0·033). INTERPRETATION An integrated multisector approach for addressing the MDGs can produce rapid declines in child mortality in the first 3 years of a long-term effort in rural sub-Saharan Africa. FUNDING UN Human Security Trust Fund, the Lenfest Foundation, Bill & Melinda Gates Foundation, and Becton Dickinson.
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Sachs JD, Remans R, Smukler SM, Winowiecki L, Andelman SJ, Cassman KG, Castle D, DeFries R, Denning G, Fanzo J, Jackson LE, Leemans R, Lehmann J, Milder JC, Naeem S, Nziguheba G, Palm CA, Pingali PL, Reganold JP, Richter DD, Scherr SJ, Sircely J, Sullivan C, Tomich TP, Sanchez PA. Effective monitoring of agriculture: a response. ACTA ACUST UNITED AC 2012; 14:738-42. [DOI: 10.1039/c2em10584e] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Remans R, Pronyk PM, Fanzo JC, Chen J, Palm CA, Nemser B, Muniz M, Radunsky A, Abay AH, Coulibaly M, Mensah-Homiah J, Wagah M, An X, Mwaura C, Quintana E, Somers MA, Sanchez PA, Sachs SE, McArthur JW, Sachs JD. Multisector intervention to accelerate reductions in child stunting: an observational study from 9 sub-Saharan African countries. Am J Clin Nutr 2011; 94:1632-42. [PMID: 22030229 DOI: 10.3945/ajcn.111.020099] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In sub-Saharan Africa, ~ 40% of children <5 y old are stunted, with levels that have remained largely unchanged over the past 2 decades. Although the complex determinants of undernutrition are well recognized, few studies have evaluated strategies that combine nutrition-specific, health-based approaches with food system- and livelihood-based interventions. OBJECTIVE We examined changes in childhood stunting and its determinants after 3 y of exposure to an integrated, multisector intervention and compared these changes with national trends. DESIGN A prospective observational trial was conducted across rural sites in 9 sub-Saharan African countries with baseline levels of childhood stunting >20%. A stratified random sample of households and resident children <2 y old from villages exposed to the program were enrolled in the study. Main outcome measures included principal determinants of undernutrition and childhood stunting, which was defined as a height-for-age z score less than -2. National trends in stunting were generated from demographic and health surveys. RESULTS Three years after the start of the program in 2005-2006, consistent improvements were observed in household food security and diet diversity, whereas coverage with child care and disease-control interventions improved for most outcomes. The prevalence of stunting in children <2 y old at year 3 of the program (2008-2009) was 43% lower (adjusted OR: 0.57; 95% CI: 0.38, 0.83) than at baseline. The average national stunting prevalence for the countries included in the study had remained largely unchanged over the past 2 decades. CONCLUSION These findings provide encouraging evidence that a package of multisector interventions has the potential to produce reductions in childhood stunting.
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Hotez PJ, Mistry N, Rubinstein J, Sachs JD. Integrating neglected tropical diseases into AIDS, tuberculosis, and malaria control. N Engl J Med 2011; 364:2086-9. [PMID: 21631320 DOI: 10.1056/nejmp1014637] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Farmer P, Almazor CP, Bahnsen ET, Barry D, Bazile J, Bloom BR, Bose N, Brewer T, Calderwood SB, Clemens JD, Cravioto A, Eustache E, Jérôme G, Gupta N, Harris JB, Hiatt HH, Holstein C, Hotez PJ, Ivers LC, Kerry VB, Koenig SP, Larocque RC, Léandre F, Lambert W, Lyon E, Mekalanos JJ, Mukherjee JS, Oswald C, Pape JW, Gretchko Prosper A, Rabinovich R, Raymonville M, Réjouit JR, Ronan LJ, Rosenberg ML, Ryan ET, Sachs JD, Sack DA, Surena C, Suri AA, Ternier R, Waldor MK, Walton D, Weigel JL. Meeting cholera's challenge to Haiti and the world: a joint statement on cholera prevention and care. PLoS Negl Trop Dis 2011; 5:e1145. [PMID: 21655350 PMCID: PMC3104956 DOI: 10.1371/journal.pntd.0001145] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Farmer P, Frenk J, Knaul FM, Shulman LN, Alleyne G, Armstrong L, Atun R, Blayney D, Chen L, Feachem R, Gospodarowicz M, Gralow J, Gupta S, Langer A, Lob-Levyt J, Neal C, Mbewu A, Mired D, Piot P, Reddy KS, Sachs JD, Sarhan M, Seffrin JR. Expansion of cancer care and control in countries of low and middle income: a call to action. Lancet 2010; 376:1186-93. [PMID: 20709386 DOI: 10.1016/s0140-6736(10)61152-x] [Citation(s) in RCA: 487] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Substantial inequalities exist in cancer survival rates across countries. In addition to prevention of new cancers by reduction of risk factors, strategies are needed to close the gap between developed and developing countries in cancer survival and the effects of the disease on human suffering. We challenge the public health community's assumption that cancers will remain untreated in poor countries, and note the analogy to similarly unfounded arguments from more than a decade ago against provision of HIV treatment. In resource-constrained countries without specialised services, experience has shown that much can be done to prevent and treat cancer by deployment of primary and secondary caregivers, use of off-patent drugs, and application of regional and global mechanisms for financing and procurement. Furthermore, several middle-income countries have included cancer treatment in national health insurance coverage with a focus on people living in poverty. These strategies can reduce costs, increase access to health services, and strengthen health systems to meet the challenge of cancer and other diseases. In 2009, we formed the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries, which is composed of leaders from the global health and cancer care communities, and is dedicated to proposal, implementation, and evaluation of strategies to advance this agenda.
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Sachs JD. Market Reforms, 20 Years Later. Sci Am 2010; 303:32. [DOI: 10.1038/scientificamerican0810-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Bloomberg MR, Sachs JD, Small GM. Climate Change Adaptation in New York City: Building a Risk Management Response. Ann N Y Acad Sci 2010; 1196:1-3. [DOI: 10.1111/j.1749-6632.2009.05415.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bloomberg MR, Sachs JD, Small GM. Forewords to climate change adaptation in New York City: building a risk management response. Ann N Y Acad Sci 2010; 1196:1. [PMID: 20545640 DOI: 10.1111/j.1749-6632.2009.05415_1.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Sachs JD. Flying Blind in Policy Reforms. Sci Am 2010; 302:32. [DOI: 10.1038/scientificamerican0510-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sachs JD. Breaking the Climate Debate Logjam. Sci Am 2010; 302:30. [DOI: 10.1038/scientificamerican0310-30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Bonds MH, Keenan DC, Rohani P, Sachs JD. Poverty trap formed by the ecology of infectious diseases. Proc Biol Sci 2009; 277:1185-92. [PMID: 20007179 DOI: 10.1098/rspb.2009.1778] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
While most of the world has enjoyed exponential economic growth, more than one-sixth of the world is today roughly as poor as their ancestors were many generations ago. Widely accepted general explanations for the persistence of such poverty have been elusive and are needed by the international development community. Building on a well-established model of human infectious diseases, we show how formally integrating simple economic and disease ecology models can naturally give rise to poverty traps, where initial economic and epidemiological conditions determine the long-term trajectory of the health and economic development of a society. This poverty trap may therefore be broken by improving health conditions of the population. More generally, we demonstrate that simple human ecological models can help explain broad patterns of modern economic organization.
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Sachs JD. The Crisis of Public Management. Sci Am 2009; 301:32. [DOI: 10.1038/scientificamerican1009-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sanchez PA, Ahamed S, Carré F, Hartemink AE, Hempel J, Huising J, Lagacherie P, McBratney AB, McKenzie NJ, Mendonça-Santos MDL, Minasny B, Montanarella L, Okoth P, Palm CA, Sachs JD, Shepherd KD, Vågen TG, Vanlauwe B, Walsh MG, Winowiecki LA, Zhang GL. Environmental science. Digital soil map of the world. Science 2009; 325:680-1. [PMID: 19661405 DOI: 10.1126/science.1175084] [Citation(s) in RCA: 386] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Sachs JD. Sustainable developments. Good news on malaria control. Sci Am 2009; 301:29. [PMID: 19634559 DOI: 10.1038/scientificamerican0809-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Sachs JD. Still Needed: A Climate Plan. Sci Am 2009; 301:32. [DOI: 10.1038/scientificamerican0709-32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sachs JD. Rethink the global money supply. Less reliance on the U.S. dollar by international reserves would be widely beneficial. Sci Am 2009; 300:34. [PMID: 19485085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Sachs JD. Needed: A Fiscal Framework. Sci Am 2009; 300:34. [DOI: 10.1038/scientificamerican0409-34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sachs JD. The need for stable policies. An exaggerated swing toward economic stimulus will only delay the return of sustainable prosperity. Sci Am 2009; 300:26. [PMID: 19253769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Sachs JD. Transforming the Auto Industry. Sci Am 2009; 300:33. [DOI: 10.1038/scientificamerican0209-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Teklehaimanot HD, Teklehaimanot A, Kiszewski A, Rampao HS, Sachs JD. Malaria in São Tomé and principe: on the brink of elimination after three years of effective antimalarial measures. Am J Trop Med Hyg 2009; 80:133-140. [PMID: 19141851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
In 2005, São Tomé e Príncipe began an initiative aimed at reducing malaria-related mortality to zero. The program included mass coverage with two antivector intervention methods (indoor residual spraying and long-lasting insecticidal nets), artemisinin-based combination therapy, and intermittent preventive therapy in pregnancy with sulfadoxine-pyrimethamine. At the end of 2007, three years after intensified interventions began, malaria-attributed outpatient consultations, hospitalizations, and deaths decreased by more than 85%, 80%, and 95%, respectively, in all age groups. Mean prevalence of parasitemia and splenomegaly were also significantly reduced to 2.1% (P < 0.0001) and 0.3% (P < 0.0001) after two rounds of spraying from baseline prevalences of 30.5% and 48.8%, respectively. The dramatic reduction in malaria morbidity and mortality now enable serious consideration of new goals and strategies aimed at completely interrupting malaria transmission on these islands. We report evidence of the program's impact and the feasibility of and potential strategies for eliminating malaria from São Tomé e Príncipe.
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Teklehaimanot HD, Kiszewski A, Teklehaimanot A, Rampao HS, Sachs JD. Malaria in São Tomé and Principe: On the Brink of Elimination after Three Years of Effective Antimalarial Measures. Am J Trop Med Hyg 2009. [DOI: 10.4269/ajtmh.2009.80.133] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Sachs JD. Looking after the Future. Sci Am 2008; 299:40. [DOI: 10.1038/scientificamerican1108-40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sachs JD. Coping with a persistent oil crisis. With global demand for cars accelerating, the best approach is to redesign cars and transport systems. Sci Am 2008; 299:38. [PMID: 18847082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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