Publications

Background

People who inject drugs (PWID) around the world are disproportionately affected by the HIV epidemic. National policy responses to the epidemic heavily influence risk factors for HIV acquisition among this key group. Prior efforts to monitor national policy responses to HIV/AIDS among PWID were limited both in scope and coverage. In this paper we develop and validate the HIV-PWID Policy Index (HPPI) to benchmark and monitor national commitments to HIV prevention and treatment among PWID.

Methods

Composite indicator was constructed employing fuzzy multilayer data envelopment analysis (FMLDEA). Model inputs based on data from 105 countries included 27 variables measured across six conceptual domains, including needle and syringe programs, opioid substitution treatment, testing and counseling, information and education, monitoring and evaluation, and legal and policy climate.

Results

According to the HPPI, which ranges from 0 to 1, the top performing countries in policy commitments to HIV prevention and treatment among PWID were Spain (0.988), Switzerland (0.982), Luxembourg (0.970), Moldova (0.970), and Kyrgyzstan (0.945), whereas the poorest performing included Nicaragua (0.094), Japan, (0.094), Cape Verde (0.097), Syria (0.174), and Benin (0.185). Regionally, commitment to HIV services targeting PWID was highest among European countries (0.81) and lowest among African countries (0.50), with Oceania (0.76), Asia (0.66), and the Americas (0.56) in the mid-range. Subregional differences were even more prominent, with West and Central European nations (0.84) and Central American nations (0.22) earning the highest and lowest HPPI scores, respectively.

Conclusions

The HPPI documented substantial national and regional variation in policy responses to the HIV epidemic among PWID. Our analysis also revealed that many countries have limited HIV/AIDS data collection and monitoring capabilities. Continued enhancement and standardization of global HIV/AIDS monitoring efforts are therefore vital to articulated national and international benchmarking and performance assessment goals.

Objectives This study provides a detailed analysis of the global and regional burden of cancer due to occupational carcinogens from the Global Burden of Disease 2016 study.Methods The burden of cancer due to 14 International Agency for Research on Cancer Group 1 occupational carcinogens was estimated using the population attributable fraction, based on past population exposure prevalence and relative risks from the literature. The results were used to calculate attributable deaths and disability-adjusted life years (DALYs).Results There were an estimated 349 000 (95% Uncertainty Interval 269 000 to 427 000) deaths and 7.2 (5.8 to 8.6) million DALYs in 2016 due to exposure to the included occupational carcinogens—3.9% (3.2% to 4.6%) of all cancer deaths and 3.4% (2.7% to 4.0%) of all cancer DALYs; 79% of deaths were of males and 88% were of people aged 55 –79 years. Lung cancer accounted for 86% of the deaths, mesothelioma for 7.9% and laryngeal cancer for 2.1%. Asbestos was responsible for the largest number of deaths due to occupational carcinogens (63%); other important risk factors were secondhand smoke (14%), silica (14%) and diesel engine exhaust (5%). The highest mortality rates were in high-income regions, largely due to asbestos-related cancers, whereas in other regions cancer deaths from secondhand smoke, silica and diesel engine exhaust were more prominent. From 1990 to 2016, there was a decrease in the rate for deaths (−10%) and DALYs (−15%) due to exposure to occupational carcinogens.Conclusions Work-related carcinogens are responsible for considerable disease burden worldwide. The results provide guidance for prevention and control initiatives.

Objectives This paper presents detailed analysis of the global and regional burden of chronic respiratory disease arising from occupational airborne exposures, as estimated in the Global Burden of Disease 2016 study.Methods The burden of chronic obstructive pulmonary disease (COPD) due to occupational exposure to particulate matter, gases and fumes, and secondhand smoke, and the burden of asthma resulting from occupational exposure to asthmagens, was estimated using the population attributable fraction (PAF), calculated using exposure prevalence and relative risks from the literature. PAFs were applied to the number of deaths and disability-adjusted life years (DALYs) for COPD and asthma. Pneumoconioses were estimated directly from cause of death data. Age-standardised rates were based only on persons aged 15 years and above.Results The estimated PAFs (based on DALYs) were 17% (95% uncertainty interval (UI) 14%–20%) for COPD and 10% (95% UI 9%–11%) for asthma. There were estimated to be 519 000 (95% UI 441,000–609,000) deaths from chronic respiratory disease in 2016 due to occupational airborne risk factors (COPD: 460,100 [95% UI 382,000–551,000]; asthma: 37,600 [95% UI 28,400–47,900]; pneumoconioses: 21,500 [95% UI 17,900–25,400]. The equivalent overall burden estimate was 13.6 million (95% UI 11.9–15.5 million); DALYs (COPD: 10.7 [95% UI 9.0–12.5] million; asthma: 2.3 [95% UI 1.9–2.9] million; pneumoconioses: 0.58 [95% UI 0.46–0.67] million). Rates were highest in males; older persons and mainly in Oceania, Asia and sub-Saharan Africa; and decreased from 1990 to 2016.Conclusions Workplace exposures resulting in COPD, asthma and pneumoconiosis continue to be important contributors to the burden of disease in all regions of the world. This should be reducible through improved prevention and control of relevant exposures.

Objectives This study provides an overview of the influence of occupational risk factors on the global burden of disease as estimated by the occupational component of the Global Burden of Disease (GBD) 2016 study.

 

Methods The GBD 2016 study estimated the burden in terms of deaths and disability-adjusted life years (DALYs) arising from the effects of occupational risk factors (carcinogens; asthmagens; particulate matter, gases and fumes (PMGF); secondhand smoke (SHS); noise; ergonomic risk factors for low back pain; risk factors for injury). A population attributable fraction (PAF) approach was used for most risk factors.

 

Results In 2016, globally, an estimated 1.53 (95% uncertainty interval 1.39–1.68) million deaths and 76.1 (66.3–86.3) million DALYs were attributable to the included occupational risk factors, accounting for 2.8% of deaths and 3.2% of DALYs from all causes. Most deaths were attributable to PMGF, carcinogens (particularly asbestos), injury risk factors and SHS. Most DALYs were attributable to injury risk factors and ergonomic exposures. Men and persons 55 years or older were most affected. PAFs ranged from 26.8% for low back pain from ergonomic risk factors and 19.6% for hearing loss from noise to 3.4% for carcinogens. DALYs per capita were highest in Oceania, Southeast Asia and Central sub-Saharan Africa. On a per capita basis, between 1990 and 2016 there was an overall decrease of about 31% in deaths and 25% in DALYs.

 

Conclusions Occupational exposures continue to cause an important health burden worldwide, justifying the need for ongoing prevention and control initiatives.

BACKGROUND: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. METHODS: We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). FINDINGS: In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). INTERPRETATION: Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.

We document the geographic concentration patterns of Russian manufacturing using detailed microgeographic data. About 80% of three‐digit industries are significantly agglomerated, and a similar share of three‐digit industry pairs is significantly coagglomerated. Industry pairs with stronger buyer–supplier links—as measured using Russian input–output tables—tend to be slightly more coagglomerated. This result is robust to instrumental variable estimation using either Canadian or US instruments. Using Canadian ad valorem transport costs as a proxy for transport costs in Russia, we further find that industries with higher transport costs are more dispersed, and industry pairs with higher transport costs are less coagglomerated.

Childhood malnutrition is associated with high morbidity and mortality globally1. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood2. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0–59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards3,4,5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization’s median growth reference standards for a healthy population6. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)7; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes8. Building from our previous work mapping CGF in Africa9, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99% of affected children live1, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications

Educational attainment is an important social determinant of maternal, newborn, and child health1–3. As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting4–6. The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness7,8; however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health9–11. Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but—to our knowledge—no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries12–14. By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations

One of the most dynamically changing parts of the labor market relates to information technologies. Skillsets demanded by employers in this sphere vary across different industries, organizations and even certain vacancies. The educational system in the most cases lags behind such changes, so that obsolete skillsets are being taught. This article proposes an algorithm of skillsets identification that allows us to extract skills that are needed by companies from different occupational groups in the information technologies sector. Using the unstructured online-vacancies database for the Russian regional labor market, skills are extracted and unified with the use of TF-IDF and n-grams approaches. As a result, key specific skillsets for various occupations are found. The proposed algorithm allows us to identify and standardize key skills which might be applicable to create a system of Russian classification for occupations and skills. In addition, the algorithm allows us to provide lists of the key combinations of skills that are in high demand among companies inside each particular occupation.

Russia has a widespread injection drug use epidemic with high prevalence of HIV and HCV among people who inject drugs (PWID). We conducted a mixed methods study of young (age 18-26) hard drug users in St. Petersburg. Thirty-nine structured and 10 semi-structured interviews were conducted. No HIV cases and two HCV cases were detected among the PWID subsample (n=29).  Amphetamine and other stimulants were common (70%), opioid use was rare and episodic. Consistent condom use was low. No PWID reported syringe-sharing, 51% reported other drug paraphernalia sharing.  Contacts with older (30+) PWID were rare. A new cohort of drug users in St. Petersburg may have emerged, which is much safer in its injection practices compared to previous cohorts. However, risky sexual practices of this new cohort may expose them to the possibility of sexual transmission of HIV and widespread drug paraphernalia sharing to the HCV epidemic.

Due to weak state and administrative capacity, the Russian government has involved resource-rich non-state actors into policy-making since about 2005 and established numerous institutionalized platforms, networks, and forums. These networks mainly emerge on regional and local levels and are designed to generate policy advice, implement decisions, and contribute to output legitimacy. A crucial question is how the authorities govern and regulate these bodies under the terms of a hybrid regime. The paper sheds light on why and how state authorities interact with non-state actors and unravels functions and flavors of governance networks in Russia. Drawing on the empirical results of case studies on anti-drug policy conducted in the regions Samara and St Petersburg, the paper reveals that state dominance within networks is a significant characteristic, although authorities rarely apply explicit ‘hard’ tools of government onto collaborations with non-state actors. The paper also allows for theorizing on the role of governance networks in a hybrid regime.

Purpose

Compared with other emerging and former command economies, Russia has low levels of entrepreneurial activity and exceptionally low levels of reported entrepreneurial intentions. Drawing on the theory of planned behaviour (TPB), this paper aims to examine the determinants of entrepreneurial intentions in Russia.

Design/methodology/approach

Using individual level data from two waves (2013 and 2018) of the Global Entrepreneurship Monitor (GEM) survey, the paper presents a range of semi-nonparametric logistic regressions estimating the determinants of reported entrepreneurial intention among the Russian adult population not already engaged in entrepreneurial activity. These data allow for the first empirical exploration of the TPB in the Russian context.

Findings

The results provide evidence in support of two (“attitudes” and “perceived behavioural control”), from three, origins of the theory of planned behaviour. Firstly, positive attitudes towards entrepreneurship, in the form of employment seeking and direct (own experience) or indirect (experience through social networks) entrepreneurial knowledge are both positively associated with intention. Secondly, individuals who consider their environment to be conducive to entrepreneurship and who believe they have the knowledge and skills required to be entrepreneurs are more likely to intend entrepreneurial action.

Originality/value

In view of the limited entrepreneurial activity and low levels of reported entrepreneurial intention in Russia, it is important to understand the drivers of these intentions if the appropriate policy responses are to be identified and adopted. This research represents the first substantive efforts to comprehensively examine the determinants of entrepreneurial intentions for Russia and allows us to propose several policy relevant conclusions.

This paper considers three hypotheses about the strategic origin of price dispersion in homogeneous product online sales. The first two are the $\varepsilon$-equilibrium and the quantal-response equilibrium (QRE) in a pure Bertrand setting involving the boundedly rational behavior of sellers. The third introduces the share of loyal consumers into the model of competition. These hypotheses were supported by estimations on experimental lab data. We test the hypotheses on a set of real prices for 30 models of household appliances collected from the largest Russian online marketplace Market.Yandex.ru. In contrast to the previously reported experimental data, we found very limited support for any of these explanations. QRE showed the best performance on the data. For most of the products it accurately predicts central tendency, i.e. the mean and the median. However, the shape of the observed price distributions is not explained well by any of the models. These results pose new challenges for theoretical explanations of observed Internet prices.

Th is paper, based on the data of sample observation of population incomes and participation in social programs for the period from 2014 to 2018 prepared by the Federal State Statistics Service, evaluates the diff erences in the incomes of employees and entrepreneurs, the latter fall into ownaccount workers and employers. In this study the methods of ordinary least squares and quantile regression are employed. Th e results show that in Russia entrepreneurs’ median and average earnings are higher than employees’ ones. Th e highest positive diff erences are in the incomes of employers who earn more than own-account workers and employees respectively. Also, entrepreneurs earn more than employees during the period of economic growth as well as recession. It indicates that the positive income diff erence between entrepreneurs and employees is kept during economic slowdowns. Th is fi nding distinguishes Russia from the countries with high income per capita and a larger contribution of small and medium-sized businesses to the gross domestic product, such as the USA, Great Britain, Germany, Finland, where entrepreneurs oft en earn less than employees. Th us, the monetary reward might be a primary reason for persons to opt for entrepreneurship in Russia than in high-income economies.

The paper contributes to empirical evidence of tourism-led growth (TLG) hypothesis. The research is based on a balanced panel data for 116 countries from the World Bank, 1995–2017. International tourism receipts, its share in GDP, and annual number of international tourist arrivals per capita are used as indicators of countries’ specialization on tourism. Granger (non) causality test as long as autoregressive distributed lags models with heterogeneous parameters and control for cross-sectional dependence are in line with the TLG-hypothesis.

The biopharmaceutical industry has always been a highly concentrated sector of the economy. This industry became a matter of great interest in Russia when import-substituting programmes grew in relevance. The implementation of the Pharma-2020 strategy, along with the stable indicators of the economic growth of the industry, facilitated the creation of cluster initiatives — both innovative and innovative local ones — in certain regions of the Russian Federation. A necessary condition for the creation of cluster initiatives is the existence of a high industrial concentration in a rather limited area. The article proposes a methodology that can be used to check whether cluster initiatives match geographic clusters; it also demonstrates how this methodology can be applied to the cluster initiatives created in Russia between 2008 and 2018 in order to verify how they match the geographical clusters established on the basis of spatial indices of industrial concentration. We have established that out of the twenty-four biopharmaceutical clusters considered, eight clusters were created in areas where the relevant industry is not geographically concentrated. We have found regions in which the geographic concentration of the biopharmaceutical industry is rather high, although regional governments did not launch cluster initiatives of the related industries. We have analyzed the structure of the biopharmaceutical cluster initiatives  and revealed that: the number of participants is insufficient; the share of industrial plants is low; the industry is not sufficiently specialized; small and average plants are involved only at an average level.

Health-related quality of life is becoming the standard measure of personal well-being and human’s health worldwide. Indicators of the population quality of life allow taking into account the subjective incidence, which is often overlooked during routine medical care. In Russia, the health-related quality of life is becoming particularly relevant in connection with the problems of an ageing population, the development of national strategies and programs in the social and healthcare systems, and the increasing prevalence of chronic diseases. The basis of the HRQoL measurement should be based on a proven and reliable methodology that generates comparable estimates of human well-being. Like any complex subjective indicator, HRQoL does not have an unambiguous direct method of measurement. The aim of this paper is a comprehensive description of the methodology for conducting and presenting the results of the study of the HRQoL using the European Quality of Life Questionnaire, EQ–5D. The paper discusses the measurement of HRQoL as a critical component of a modern health care system, describes in detail the administration of HRQoL data using the EQ–5D–3L questionnaire, and provides a methodology for analyzing and presenting the collected data in studies of population and patient health. We address the discussion to clinicians, healthcare providers, and researchers dealing with the problems of studying and measuring the health-related quality of life.