A Comparative Analysis of the Old Medical Structure and the ACO Vision 2030 in Saudi Arabia

This article explores the progress of the healthcare sector in the Kingdom of Saudi Arabia over the past two decades. Through continuous coordination and efforts to improve the quality and quantity of health services, the government has significantly increased the availability of health facilities across the nation. This steady growth has allowed the country to maintain an upward trajectory in healthcare sector development in comparison to other countries. The Saudi Arabian government is preparing to implement Accountable Care Organizations (ACOs) as part of their “Vision 2030.” By aligning with the goals of this visionary roadmap, the government aims to address the challenges faced by the existing healthcare system under the Ministry of Health (MOH). This strategic move is expected to transform the healthcare sector, positioning Saudi Arabia at par with its international counterparts and bolstering its economic competitiveness. This article highlights the historical context of Saudi Arabia’s healthcare system, and compares it with the forthcoming ACO implementation under “Vision 2030.” This information provides valuable insights into the trajectory of the country’s healthcare landscape and the potential impact of ACOs in shaping the Kingdom’s future in healthcare and economic development overall.

Inequity in the global distribution of monkeypox vaccines

Monkeypox(mpox)has been a public health emergency of international concern that emerged in mid-2022 and has spread to 110 countries.The clinical findings of the disease vary according to the seriousness of the cases.Although its case fatality risk has not been high,a significant percentage of patients require hospitalization.In this context,local initiatives were taken to extend the limited supply of vaccines against the disease;however,such measures have not been sufficient to contain the spread of cases and ensure an equitable distribution of health resources.As a result,endemic regions of low-income countries continue to have insufficient access to mpox vaccination.Despite this and considering the global scope of the disease,there is still little discussion in the literature about the difficulties in achieving adequate vaccination coverage rates for the target population of interest.In this article,we briefly discussed general aspects of the disease,including its surveillance,the current global context of challenges for mpox vaccination,and issues on global allocation of health resources as well as proposed related recommendations.

The Impact of HIV Spending on Health Outcomes in Thailand

Background: The Sustainable Development Goals commitment to Ending HIV/AIDS by 2030 requires sustained adequate investment. This study sought to examine the association between HIV/AIDS spending and outcomes in Thailand between 2008 and 2019. Methods: A quantitative secondary data analysis with time-series was conducted using a retrospective dataset of HIV spending and some selected outcomes including the number of people living with HIV (PLHIV), incidence and prevalence of HIV/AIDS, the prevention of mother-to-child transmission (PMTCT) and AIDS-related deaths. Data were obtained from a diverse set of sources. Descriptive statistics and univariate regression model were used to analyze HIV expenditure and outcomes. Results: HIV spending per PLHIV rose by two folds from $347 in 2008 to more than $600 in 2019, mostly financed by domestic sources. This increase of domestic resources per PLHIV was significantly associated with better HIV-related outcomes especially in the reduction of PLHIV and AIDS-related deaths through increased number of people receiving antiretroviral therapy (ART). However, the spending per PLHIV varied across the three public health insurance schemes. Comparison of HIV expenditure and health outcomes across upper-middle-income countries shows Thailand is not highly ranked in terms of spending efficiency despite having made good progress. Conclusion: Domestic financing for HIV programs is indispensable for achieving the goal of ending AIDS. Despite significant improvement in HIV-related outcomes, challenges remain in achieving the 90-90-90 goal. The redesigning of payment methods should be considered to increase the efficiency of HIV financing. Other factors related to strengthening the health system should not be overlooked.

Access to and affordability of healthcare for TB patients in China: issues and challenges

This paper introduces the background,aim and objectives of the project entitled“China—the Gates Foundation Collaboration on TB Control in China”that has been underway for many years.It also summarizes the key findings of the nine papers included in this special issue,which used data from the baseline survey of Phase II of the project.Data were collected from the survey of TB and MDR-TB patients,from designated hospitals,health insurance agencies and the routine health information systems,as well as key informant interviews and focus group discussions with relevant key stakeholders.Key issues discussed in this series of papers include the uses of TB services and anti-TB medicines and their determining factors related to socio-economic and health systems development;expenditures on TB care and the financial burden incurred on TB patients;and the impact of health insurance schemes implemented in China on financial protection.