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: Introduction: Antiretroviral therapy (ART) and tuberculosis preventive treatment (TPT) both prevent tuberculosis (TB) disease and deaths among people living with HIV. Differentiated care models, including community‐based care, can increase the uptake of ART and TPT to prevent TB in settings with a high burden of HIV‐associated TB, particularly among men. Methods: We developed a gender‐stratified dynamic model of TB and HIV transmission and disease progression among 100,000 adults ages 15−59 in KwaZulu‐Natal, South Africa. We drew model parameters from a community‐based ART initiation and resupply trial in sub‐Saharan Africa (Delivery Optimization for Antiretroviral Therapy, DO ART) and other scientific literature. We simulated the impacts of community‐based ART and TPT care programmes during 2018−2027, assuming that community‐based ART and TPT care were scaled up to similar levels as in the DO ART trial (i.e. ART coverage increasing from 49% to 82% among men and from 69% to 83% among women) and sustained for 10 years. We projected the number of TB cases, deaths and disability‐adjusted life years (DALYs) averted relative to standard, clinic‐based care. We calculated programme costs and incremental cost‐effectiveness ratios from the provider perspective. Results: If community‐based ART care could be implemented with similar effectiveness to the DO ART trial, increased ART coverage could reduce TB incidence by 27.0% (range 21.3%−34.1%) and TB mortality by 34.6% (range 24.8%–42.2%) after 10 years. Increasing both ART and TPT uptake through community‐based ART with TPT care could reduce TB incidence by 29.7% (range 23.9%−36.0%) and TB mortality by 36.0% (range 26.9%−43.8%). Community‐based ART with TPT care reduced gender disparities in TB mortality rates, with a projected 54 more deaths annually among men than women (range 11–103) after 10 years of community‐based care versus 109 (range 41–182) in standard care. Over 10 years, the mean cost per DALY averted by community‐based ART with TPT care was $846 USD (range $709–$1012). Conclusions: By substantially increasing coverage of ART and TPT, community‐based care for people living with HIV could reduce TB incidence and mortality in settings with high burdens of HIV‐associated TB and reduce TB gender disparities., INTRODUCTION Tuberculosis (TB) is the leading cause of death globally among people living with HIV (PLWH) [1]. HIV acquisition markedly increases the risk of progression to active TB disease [2]. [...]

Through sustainable development goals 3 and 8 and other policies, countries have committed to protect and promote workers' health by reducing the work-related burden of disease. To monitor progress on these commitments, indicators that capture the work-related burden of disease should be available for monitoring workers' health and sustainable development. The World Health Organization and the International Labour Organization estimate that only 363 283 (19%) of 1 879 890 work-related deaths globally in 2016 were due to injuries, whereas 1 516 607 (81%) deaths were due to diseases. Most monitoring systems focusing on workers' health or sustainable development, such as the global indicator framework for the sustainable development goals, include an indicator on the burden of occupational injuries. Few such systems, however, have an indicator on the burden of work-related diseases. To address this gap, we present a new global indicator: mortality rate from diseases attributable to selected occupational risk factors, by disease, risk factor, sex and age group. We outline the policy rationale of the indicator, describe its data sources and methods of calculation, and report and analyse the official indicator for 183 countries. We also provide examples of the use of the indicator in national workers' health monitoring systems and highlight the indicator's strengths and limitations. We conclude that integrating the new indicator into monitoring systems will provide more comprehensive and accurate surveillance of workers' health, and allow harmonization across global, regional and national monitoring systems. Inequalities in workers' health can be analysed and the evidence base can be improved towards more effective policy and systems on workers' health. Par le biais des objectifs de developpement durable 3 et 8 ainsi que d'autres mesures, plusieurs pays se sont engages a proteger et promouvoir la sante des travailleurs en reduisant l'impact des maladies liees au travail. Mais pour evaluer leurs progres en la matiere, il convient de mettre en place des indicateurs estimant l'impact des maladies liees au travail afin de placer le developpement durable et la sante des travailleurs sous surveillance. D'apres l'Organisation mondiale de la Sante et l'Organisation internationale du Travail, seulement 363 283 (19%) des 1 879 890 deces lies au travail dans le monde en 2016 decoulaient de blessures, tandis que 1 516 607 (81%) d'entre eux etaient causes par des maladies. La plupart des systemes de surveillance qui s'interessent a la sante des travailleurs ou au developpement durable, comme le cadre mondial d'indicateurs pour les objectifs de developpement durable, comportent un indicateur relatif a l'impact des accidents de travail. Cependant, rares sont ceux qui possedent un indicateur concernant l'impact des maladies professionnelles. Pour combler cette lacune, nous devoilons un nouvel indicateur mondial: le taux de mortalite du aux maladies attribuables a certains facteurs de risque professionnels classe par maladie, facteur de risque, sexe et categorie d'age. Nous exposons le motif politique de l'indicateur, decrivons l'origine des donnees et les methodes de calcul, et communiquons et analysons l'indicateur officiel pour 183 pays. Nous fournissons egalement des exemples de la facon dont l'indicateur peut etre utilise dans des systemes nationaux de surveillance de la sante des travailleurs et soulignons ses forces et faiblesses. Nous concluons en affirmant que l'integration de ce nouvel indicateur dans les systemes de surveillance offrira un suivi plus complet et precis de la sante des travailleurs et ouvrira la voie a une harmonisation des systemes mondiaux, nationaux et regionaux. Il est possible d'analyser les inegalites en matiere de sante des travailleurs et d'en ameliorer les bases factuelles afin d'etablir des politiques et systemes plus efficaces dans ce domaine. A traves de los objetivos de desarrollo sostenlble 3 y 8 y de otras politicas, los paises se han comprometido a proteger y promover la salud de los trabajadores reduciendo la carga de morbilidad relacionada con el trabajo. Para supervisar los avances en el cumplimiento de estos compromisos, deberia disponerse de indicadores que reflejen la carga de morbilidad relacionada con el trabajo, a fin de controlar la salud de los trabajadores y el desarrollo sostenible. La Organizacion Mundial de la Salud y la Organizacion Internacional del Trabajo estiman que solo 363 283 (19%) de las 1 879 890 muertes relacionadas con el trabajo a nivel mundial en 2016 se debieron a lesiones, mientras que 1 516 607 (81%) muertes se debieron a enfermedades. La mayoria de los sistemas de vigilancia centrados en la salud de los trabajadores o el desarrollo sostenible, como el marco de indicadores mundiales para los objetivos de desarrollo sostenible, incluyen un indicador sobre la carga de las lesiones laborales. No obstante, pocos de estos sistemas cuentan con un indicador sobre la carga de las enfermedades relacionadas con el trabajo. Para subsanar esta carencia, presentamos un nuevo indicador mundial: la tasa de mortalidad por enfermedades atribuibles a factores de riesgo laborales seleccionados, por enfermedad, factor de riesgo, sexo y grupo de edad. Describimos la justificacion politica del indicador, describimos sus fuentes de datos y metodos de calculo, e informamos y analizamos el indicador oficial para 183 paises. Tambien proporcionamos ejemplos del uso del indicador en los sistemas nacionales de vigilancia de la salud de los trabajadores y destacamos las ventajas y las limitaciones del indicador. Concluimos que la integracion del nuevo indicador en los sistemas de vigilancia proporcionara una vigilancia mas exhaustiva y precisa de la salud de los trabajadores, y permitira la armonizacion entre los sistemas de vigilancia mundiales, regionales y nacionales. Se podran analizar las desigualdades en la salud de los trabajadores y se podra mejorar la base de evidencias para lograr politicas y sistemas mas eficaces en materia de salud de los trabajadores., Introduction Countries have made policy commitments through the sustainable development goals (SDGs) to ensure health and promote decent work for all. (1) SDG targets 3.9 and 8.8 are to 'substantially [...]

Antimicrobial resistance is a public health threat; global and national action plans that address this challenge should therefore be fit for purpose. Such plans should focus on preventing infectious diseases [...]