Evaluation of integration in WHO's tuberculosis, HIV, and antimicrobial resistance policies through the social-ecological lens.

IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Jian Yang, Jiabin Xu, Christoph Benn, Xiaoyi Yu, Ying Chen, Shuduo Zhou, Zhongfei Pei, Yunxuan Hu, Ming Xu
{"title":"Evaluation of integration in WHO's tuberculosis, HIV, and antimicrobial resistance policies through the social-ecological lens.","authors":"Jian Yang, Jiabin Xu, Christoph Benn, Xiaoyi Yu, Ying Chen, Shuduo Zhou, Zhongfei Pei, Yunxuan Hu, Ming Xu","doi":"10.1186/s12992-025-01150-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>TB, HIV, and AMR are closely related global health challenges. In the context of limited global health funds and insufficient resources, an integrated tuberculosis, HIV and antimicrobial resistance prevention and control method will play an important role in the optimization of resources and cost-effectiveness.</p><p><strong>Objective: </strong>This study aims to analyze the degree of policy integration for issues of tuberculosis, HIV and antimicrobial resistance in global health strategies and make recommendations for improving global health governance on related issues.</p><p><strong>Methods: </strong>We conducted a thorough analysis of global health policy documents from January 2015 to February 2024, using both quantitative and qualitative approaches. Our focus was on assessing the integration effectiveness of current global health governance mechanisms in addressing tuberculosis, HIV, and antimicrobial resistance from the global governance view based on the content analysis through word frequency analysis and thematic framework analysis. Besides, we conduct a thematic framework analysis of the action plans and policy recommendations outlined in the most recent reports from UNAIDS, Stop TB, and UNEP on HIV, TB and AMR.</p><p><strong>Results: </strong>The analysis revealed that most documents address TB, HIV, and AMR in isolation, with limited integration and intersectionality. TB and HIV are more frequently linked, while AMR is less associated with the other two. The proposed action lacks specific provisions for joint implementation or monitoring of the evaluation. Additionally, no documented comprehensive overview includes the overall framework of three health priorities.</p><p><strong>Conclusions: </strong>The study found that the current global health governance mechanism is significantly inadequate in dealing with integration solutions among tuberculosis, HIV and antimicrobial resistance. So we propose establishing integrated governance and coordination mechanisms for the same population at both horizontal and vertical levels, including individual, interpersonal, community, institutional, and societal levels, and developing an integrated policy framework to facilitate better resolution to address the association between TB, HIV infection and antimicrobial resistance in a resource-limited context.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"53"},"PeriodicalIF":4.5000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482740/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Globalization and Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12992-025-01150-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0

Abstract

Background: TB, HIV, and AMR are closely related global health challenges. In the context of limited global health funds and insufficient resources, an integrated tuberculosis, HIV and antimicrobial resistance prevention and control method will play an important role in the optimization of resources and cost-effectiveness.

Objective: This study aims to analyze the degree of policy integration for issues of tuberculosis, HIV and antimicrobial resistance in global health strategies and make recommendations for improving global health governance on related issues.

Methods: We conducted a thorough analysis of global health policy documents from January 2015 to February 2024, using both quantitative and qualitative approaches. Our focus was on assessing the integration effectiveness of current global health governance mechanisms in addressing tuberculosis, HIV, and antimicrobial resistance from the global governance view based on the content analysis through word frequency analysis and thematic framework analysis. Besides, we conduct a thematic framework analysis of the action plans and policy recommendations outlined in the most recent reports from UNAIDS, Stop TB, and UNEP on HIV, TB and AMR.

Results: The analysis revealed that most documents address TB, HIV, and AMR in isolation, with limited integration and intersectionality. TB and HIV are more frequently linked, while AMR is less associated with the other two. The proposed action lacks specific provisions for joint implementation or monitoring of the evaluation. Additionally, no documented comprehensive overview includes the overall framework of three health priorities.

Conclusions: The study found that the current global health governance mechanism is significantly inadequate in dealing with integration solutions among tuberculosis, HIV and antimicrobial resistance. So we propose establishing integrated governance and coordination mechanisms for the same population at both horizontal and vertical levels, including individual, interpersonal, community, institutional, and societal levels, and developing an integrated policy framework to facilitate better resolution to address the association between TB, HIV infection and antimicrobial resistance in a resource-limited context.

Clinical trial number: Not applicable.

从社会生态角度评价世卫组织结核病、艾滋病毒和抗菌素耐药性政策的整合情况。
背景:结核病、艾滋病毒和抗生素耐药性是密切相关的全球卫生挑战。在全球卫生资金有限、资源不足的情况下,结核病、艾滋病毒和抗菌素耐药性综合防控方法将在优化资源和成本效益方面发挥重要作用。目的:本研究旨在分析全球卫生战略中结核病、艾滋病毒和抗微生物药物耐药性问题的政策整合程度,并为完善相关问题的全球卫生治理提出建议。方法:采用定量和定性方法对2015年1月至2024年2月期间的全球卫生政策文件进行了全面分析。我们的重点是从全球治理的角度,基于词频分析和专题框架分析的内容分析,评估当前全球卫生治理机制在应对结核病、艾滋病毒和抗菌素耐药性方面的整合效果。此外,我们对联合国艾滋病规划署、遏制结核病和联合国环境规划署关于艾滋病毒、结核病和抗生素耐药性的最新报告中概述的行动计划和政策建议进行了专题框架分析。结果:分析显示,大多数文献孤立地处理TB、HIV和AMR,整合和交叉性有限。结核病和艾滋病毒更频繁地联系在一起,而抗菌素耐药性与其他两者的联系较少。拟议的行动缺乏联合执行或监测评价的具体规定。此外,没有记录在案的全面概述包括三个卫生优先事项的总体框架。结论:研究发现,目前的全球卫生治理机制在处理结核病、艾滋病毒和抗菌素耐药性的综合解决方案方面明显不足。因此,我们建议在横向和纵向两个层面建立针对同一人群的综合治理和协调机制,包括个人、人际、社区、机构和社会层面,并制定综合政策框架,以便在资源有限的情况下更好地解决结核病、艾滋病毒感染和抗菌素耐药性之间的关系。临床试验号:不适用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Globalization and Health
Globalization and Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
18.40
自引率
1.90%
发文量
93
期刊介绍: "Globalization and Health" is a pioneering transdisciplinary journal dedicated to situating public health and well-being within the dynamic forces of global development. The journal is committed to publishing high-quality, original research that explores the impact of globalization processes on global public health. This includes examining how globalization influences health systems and the social, economic, commercial, and political determinants of health. The journal welcomes contributions from various disciplines, including policy, health systems, political economy, international relations, and community perspectives. While single-country studies are accepted, they must emphasize global/globalization mechanisms and their relevance to global-level policy discourse and decision-making.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信