A Framework Convention on Global Health FCGH supported by ci

A Framework Convention on Global Health (FCGH)—supported by civil society and global leaders—should become the centrepiece of this endeavour (). It would reform global governance for health to enhance accountability, transparency, and civil society participation and protect the right to health in trade, investment, climate change, and other international regimes, while catalysing governments to institutionalise the right to health at GPCR Compound Library through to national levels. It would usher in a new era of global health with justice—vast improvements in health outcomes, equitably distributed.
Pneumonia persists as the leading infectious killer of children worldwide. Hypoxaemia is a predictor of mortality from childhood pneumonia, and approximately 1·5 million children with severe pneumonia require oxygen treatment each year. Pulse oximetry and oxygen are key interventions for treating pneumonia and preventing death. Pulse oximetry, the standard for detecting hypoxaemia, is cost-effective and can identify 20–30% more cases than using clinical signs alone. In addition to averting deaths, oximetry helps identify children requiring referral, increases the number of correctly treated severe pneumonia cases, and reduces the incidence of incorrect treatment with antibiotics. Early identification of hypoxaemia with oximetry and appropriate treatment with oxygen are lifesaving; yet availability and access to both services remain inadequate in low-resource settings. There is an urgent need to increase access to oxygen and pulse oximetry in low-resource settings. Recent WHO guidance comprising a publication of technical specifications for oxygen concentrators intended for use in low-resource settings, an expansive manual on the management of hypoxaemia, and identification of oxygen as a critical service in the care of newborns has strengthened the call for improving access to these essential tools. Further consideration is being given to including hypoxaemia as a general danger sign in the integrated management of acutely ill children. Engagements with suppliers and interested governments have established Luxury genes safe and reliable provision of oxygen requires a systems approach with wrap-around services including maintenance, training, and supervision, plus strong linkages between different health system levels. This approach necessitates thinking of oxygen and oximeters as a service requiring careful planning, rather than simply as commodities which require procurement and distribution. In Ethiopia, Nigeria, and Papua New Guinea work is underway to better understand how health systems can include safe and reliable identification of severe illness and treatment of hypoxaemic patients. Ethiopia has been a leader in planning for such an effort. Ethiopia has experienced significant improvements in its health system and the health status of its population, reducing its under-5 mortality by two-thirds between 1990 and 2012, and successfully meeting Millennium Development Goal 4 on child survival. However, pneumonia remains a leading cause of under-5 deaths. The complexity and comorbidity of the residual mortality will require greater focus on referral linkages and supportive care systems in order to maintain the significant pace of mortality decline observed between 2000 and 2015. Currently, many Ethiopian health centres do not have fully functional oxygen cylinders, concentrators, or oximeters available. Standard operating procedures or job aids for safe and effective oxygen therapy or identification of children with hypoxaemia or severe disease are not common, and often no staff are trained in providing oxygen therapy. Additionally, there are no policies and adapted guidelines for the use of oxygen and oximetry. This lack of access to oxygen and pulse oximetry is not unique to Ethiopia. It is a familiar situation throughout much of the world, particularly in rural areas with limited access to care services.