The global distribution of lymphatic filariasis, 2000–18: a geospatial analysis
Background
Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA) of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection.
Methods
A global dataset of georeferenced surveyed locations was used to model annual 2000–18 lymphatic filariasis prevalence for 73 current or previously endemic countries. We applied Bayesian model-based geostatistics and time series methods to generate spatially continuous estimates of global all-age 2000–18 prevalence of lymphatic filariasis infection mapped at a resolution of 5 km2 and aggregated to estimate total number of individuals infected.
Findings
We used 14 927 datapoints to fit the geospatial models. An estimated 199 million total individuals (95% uncertainty interval 174–234 million) worldwide were infected with lymphatic filariasis in 2000, with totals for WHO regions ranging from 3·1 million (1·6–5·7 million) in the region of the Americas to 107 million (91–134 million) in the South-East Asia region. By 2018, an estimated 51 million individuals (43–63 million) were infected. Broad declines in prevalence are observed globally, but focal areas in Africa and southeast Asia remain less likely to have attained infection prevalence thresholds proposed to achieve local elimination.
Interpretation
Although the prevalence of lymphatic filariasis infection has declined since 2000, MDA is still necessary across large populations in Africa and Asia. Our mapped estimates can be used to identify areas where the probability of meeting infection thresholds is low, and when coupled with large uncertainty in the predictions, indicate additional data collection or intervention might be warranted before MDA programmes cease.
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Health workforce issues and recommended practices in the implementation of Universal Health Coverage in the Philippines: a qualitative study.
The Philippines' Universal Health Coverage program faces a critical workforce crisis that threatens its very foundation. A new Ateneo de Manila University study reveals that while the country exports healthcare workers globally, it struggles to retain the professionals needed for its own ambitious health reforms. With only 7.92 physicians per 10,000 population and a shortage of 127,000 nurses, systemic barriers—from restrictive hiring policies to uncompetitive salaries—are driving away the very people meant to deliver healthcare for all Filipinos. The research identifies promising solutions, including scholarship programs and comprehensive benefits, but warns that without addressing these fundamental workforce issues, universal healthcare remains at risk.
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Measuring and Understanding Geographic Inequities in Physician Distribution in the Philippines
Access to quality health care in the Philippines is shaped not only by the availability of physicians, but also by how equitably they are distributed across regions. Many communities, particularly in rural and geographically isolated areas, continue to face limited access to medical professionals, while urban centers often see a concentration of physicians and specialists. The project Measuring and Understanding Geographic Inequities in Physician Distribution in the Philippines seeks to address this challenge by providing a clear, evidence-based picture of physician maldistribution nationwide.