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This too has major social and economic consequences, almost all very positive.
Ukhamas aka sarantawix kusakirakiw jakawinakapatak uñjasiski.
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This focuses not only on tackling mental disorder, but on positively improving mental health.
Aka amuyux janiw aka salud mental sat usutaki amuyutakiti, jan ukasti suma k’umara p’iqina amuyuñapataki.
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It established a series of targets and recommended actions for Member States, and for bodies including WHO.
Wali aka amuyukak suma thakiruw irpatayna ukat ixwarakitaynaw aka istadu ukankirinakaruwa ukampirusa OMS ukanakampiruwa.
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WHO has had a Mental Health Gap Action Programme in place since 2008, launched by the Director-General.
OMS sartayirix mä lurt’awinaka aka p’iqi amuyut jist’artayi aka amuyunakax 2008 maranakatpachaw sarantatäskaraki.
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This works to improve the care for a people with a prioritised set of conditions (depression, dementia, psychoses, epilepsy, and others) in 90 countries, primarily in resource-poor settings.
Aka irnaqawixa wali sumamtañapatakiwa watt’ayataskaraki., kunayman p’iqit usunikakatakiwa (armt’asis usu, llakisiñanakan usupa lukuptaña usu, waq’akiñ usu ukat yakha usunakamp) 90 markanakana, juk’ampis pisin jakirinakana.
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WHO initiatives including the current Depression: Let’s Talk campaign, have brought important mental health issues to greater prominence.
OMS amuyt’atapanakaxa,aka kampañampix aka llakintasiñ usunakxatwa wali uñakipasipkaraki.
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On World Mental Health Day 2012, WHO partnered with writer and illustrator Matthew Johnstone, releasing a short video “I had a black dog, his name was depression”.
2012 märanxa OMS p’iqi amuyut usunakxatwa taqi uraqpachan aka Matthew Johnstone qillqirimpiw jikthaptapxatayna, ukat mä wiriyu apsurakitayna,”mä ch’iyar anuniyatwa,sutipasti llakintasiña satanwa”.
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The aim was to raise awareness, and to encourage people with depression to take effective actions to help tame their own black dog.
Aka wiriyu apsutapaxa jaqinakaru uñist’ayañatakinwa akanakaxa yanapirakiw ch’iyar anuparu.
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The video has so far been viewed 7.5 million times on YouTube.
Wiriyuxa 7.5 waranqa waranqa uñjanirinakarakiwa aka You Tuve uka uñañanxa.
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WHO has estimated that 4.4% of the world’s population is suffering from depression (more than 300 million people), 3.8% from anxiety, and that there are nearly 800,000 suicides every year.
OMS ukax 4,4 jaqinakaw aka llakisiña, kuliraña usunakampiwa t’aqisi (300 waranqa jaqinakwa),3,8 uka llakisiñ usunakampir 800.000 ukha jaqinakaw jiwayasiraki ,sapa maraxa.
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Mental health makes an appearance in the targets of the Sustainable Development Goals.
Aka p’iqit usut jaquinakaxa wali uñstaskaraki aka sartawinakanxa.
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Globally, the important expansion in life expectancy over the last decade has been driven by a number of changes, including: • The reduction in under-5 mortality rate of 32% between 2005 and 2015 • The fall in the maternal mortality ratio of 25% over the same period • The HIV mortality rate drop of 50% • The drop in the malaria mortality rate of 49% • The reduction in the age-specific risk of cardiovascular disease mortality of 14% • The reduction in the age-specific risk of cancer mortality of 11% • The 7% drop in the injury mortality rate.
Jacha mark jakawinxa, aka tunka maranakanx markachirinakan jakaw urupax mayxt`awayjarakiw minrantawipata, sañani: • Jiwirinakat 5 marat manqhar 32% 2005 marat 2015 marar apaqtjarakiwa • Jiwirinakat warminakanx 25% ukjarakiw pachpa marana • Jiwirinakat ñankha usump VIH 50% ukjarurakiw apaqt`asjaraki • Jiwirinakat ñankha usump Malaria sat sutin 49% ukjarurakiw apaqt`asiraki • Jiwirinakat chuyma usutanakat 14% apaqt`atawa • Jiwirinakat “cáncer” usump 11% apaqt`atawa • Jiwirinakat usuchjatanak 7% apaqt`atawa.
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It is to be hoped that, a decade from now, mental health will have moved more firmly into the spotlight.
Suyañarakiwa ,aka tunka khipa märanak uka p’iqi usunakatx wali yatitaskaniwa.
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Over the last five years, the important issue of dementia has come to greater prominence.
Aka phisqa märanakanxa wali uñjataskiwa aka p’iqi usunakatxa.
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In May 2017, the World Health Assembly will review a Dementia Action Plan.
2017 mayu phaxsinxa,taqpach urakin tantachasiwinxa suma uñakipasipkani aka p’iqi jan amtasiñ usunakxata.
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In 2013, the G8 held a special summit on dementia.
2013 maranxa, uka G8 wali wakiskir tantachaw Dementianx wakt’ayapxatayna.
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Speaking at that event, WHO Director-General Dr Margaret Chan said: “Dementia is a costly and heart-breaking epidemic with an immense impact, medically, psychologically, emotionally, and financially.
Uka phunch’awi yanapt’iwinsti OMS tirikturapaw, Margaret Chan sataxa, sarakitaynawa: Akia p’iqit jan amtasir usunakaxa wali jan wali usuwa ,wali jila qullqitaki, ratuki t’uwantayiri ukatja qullqi apsusir usuwa.
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I can think of no other condition that has such a profound effect on loss of function, loss of independence, and the need for care.
Janiw nayax yakha amuyujax utjkaspati wali sapa tukuyir usu äkhanakan yanapa mayiña ukham usuwa.
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I can think of no other condition that places such a heavy burden on society, families, communities, and economies.
Nayax janiw yäkha amuykarakiristi aka jan wiykatir usunakax wali qullqitakiwa.
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I can think of no other condition where innovation, including breakthrough discoveries, is so badly needed.” Tackling noncommunicable disease is complex.
Nayax janiw lup’karakiristi kunayman amuyunakatxa “ jan wiykatir usunakax wali chama yatiñawa.
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The complexity is increasingly being embraced, and this must continue and grow.
Sapurü jan usu wiykatirinakax sarantañapa, jilañapa.
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Tackling noncommunicable disease involves engaging far beyond the sphere of health and healthcare, to tackle the causes at their root.
Aka jan wiykatir usunakaxa saphitpachaw thaqthapiñaspaw chhaqhañapatakixa.
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The first four of these in particular were the areas of the three primary Millennium Development Goals related to health: to reduce child mortality, to improve maternal health, and to combat HIV, malaria, and other diseases.
Nayraqat pusi qillqatanakax aka suma jakawisatak thakinchatawa, kunatix jan juk`amp wawanakat jiwatanak utjañapataki, mama warminakan suma jakañapataki ukhamas ñankha usunak VIH, Malaria atipt`añataki.
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It involves dealing with vested interests – working productively with industry if possible, and drawing red lines if not.
Suma irnaqañawa wila thaqhi sarantayaña.
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It involves being criticised as a Nanny – a hazard that communicable disease programmes do not have to bear.
Wawa uywirjamaw uñch’ukitaña ,wali jan waliwa aka wiykatir usunakaxa.
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It involves sustained political will.
Politikan munañap katt’atawa.
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And it requires building health systems that can deliver an increasingly sophisticated spectrum of prevention, treatment and care.
Wakisiw qullanaka uñstayaña sapa ñanqha usunakataki, wali suma ch’urqhi qullanakaw churañaspa usunaka jarq’aqasiñataki.
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It is not easy – but it is central to the future of public health globally.
Jani jasakiti,jan ukasti wali askispaw aka uraquitaki uka qullanaka uñstayañaxa.
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The Commission on Social Determinants of Health led by British-Australian epidemiologist, Sir Michael Marmot, presented its report to the Director-General of WHO in the summer of 2008.
Commission on Social Determinants of Healt ukax Epidemiólogo britanico-austrialiano, Sir Michael Marmot sat jaqix tiriktur jiniral OMS uksaruw khanañchataña. 2008 uka waña pacha maranwa.
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In welcoming the report, Dr Chan said: “Health systems will not naturally gravitate towards equity” and called for “Unprecedented leadership to compel all actors, including those beyond the health sector to examine their impact on health.” WHO has had a longstanding commitment to health equity, but in presenting to the world the work of its Commission, Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health, it fired the starting gun on a deeper and more fundamental approach linking equity, social justice, poverty and health, driven by some of the compelling inequalities spelled out in the report at the time of its launch: • Life expectancy for Indigenous Australian males shorter by 17 years than all other Australian males • Maternal mortality 3–4 times higher among the poor than among the rich in Indonesia • Child mortality in the slums of Nairobi is 2.5 times higher than in other parts of the city • A baby born to a Bolivian mother with no education had a greater than 10% chance of dying in the first year, while one born to a woman with at least secondary education had less than a 0.4% chance • In Uganda, the death rate of children under 5 years in the richest fifth of households was 106 per 1000 live births but in the poorest fifth of households in Uganda it was even worse – 192 deaths per 1000 live births (that was nearly a fifth of all babies born alive to the poorest households destined to die before they reach their fifth birthday).
Qullir Chan sat jaqixa wali sumrak qatuqatayna ukat sataynawa: “Aka qulla saratanakax janiw kikipa chikatakiti.” Mayirakiwa”mä jilir irpir taqini ist’apxañapataki, ukampirusa jan qullat yatirinakarusa uka kipkarakiwa, suma uñakipaña aka qullanakxata suma yant’anaka lurapxañapataki”. OMS ukanakax walpunrak katxatawayapxatayna aka qulla yatiñ utampixa sarnaqawinakampi, iukampirus uka Comisiontuqiw kunayman luratanak uñacht’ayapxatayna: K’umar Jakañax taqinitakispa, uka marakachirinak taypinxa, ukhamarak sarnaqawinakasa ukhamraki qulla sattanakampisa sumrak amuyt’asipxatayna, ukham uka yatiy papilanakapanx parlaraki: • Australiano jaqinakatakixa 17 marakiw jakañapaxa uñjataxi. • Wawani mamanakax 3-4 yapt’ataw pist’atan sarnaqir warminakan jiwari, Nayrobi ukanx 2.5 apxatataw markanakana jiwaski. • Mä wawan Bolivia mamaninak jan liyiña ni qillqaña uñt’atanakax 10% ukhaw jirapaxi mayïr maranxa.jan ukasti mamanakana liy’tiripki qillqt’iripki ukanakanxa 0.4% ukhanakakiwa kiwasipkaraki. • Uganda uka markanxa 5 märan jisk’a wawanakax utjir wila masinakanxa 106 jiwatanakaw sapa 1000 wawanakaw jan utjirinakan jiwarawayapxi uka pisin jakir markanakanxa Ugandanx juk’ampipuniwa - 192 jiwatanakatx 1000 jakaskirinakawa (ukax niy phisqha maran wawanakatx uka pisin qamir markanakanx janir phisqha mar purkasaw jiwxapxi).
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Despite the stark statistical picture that the Commission revealed, its report was not all bad news.
Uka uñist’awitxa kumisionax janiw uka jan wali yatiyäwikikarakiti,walja uñt’anakaw utjaskaraki.
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There were many examples where targeted action, local and country innovation, and committed leadership were making a difference.
Aka inuwasiyuna sataru iraqataskarakiwa aka markana anqax markansa mayjasjarakiwa.
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The examples highlighted in the report included: a comprehensive approach to early childhood development in poor Jamaican communities; the establishment of universal child development services in Cuba; and, the expansion of pre-primary education for socially disadvantaged children in Chile.
Jamaica markanxa jiska nayraqat jisk’a lalanakax juk’am sartañapatakiwa Cuwa markansa; ukat aka yatichhaw jisk’a lalanakatakix mä iraqtataw utjañapa.Chili markam wawa jakirinakatakisa.
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Since the beginning of the 21st Century, the march of globalization has quickened, the world has suffered a major financial crisis, whilst serious armed conflicts and deteriorating security situations in some parts of the world have led to displacements and migration of populations on a massive scale.
Siglo 21 maran qhalltawinxa, markan mayjt’awinakapatak sayt’apxaraki, jach’a markasan qamawisanx jan wali ch’axwawinakaw uñjasirakina, kunatix qullqitsa, phamilianakan llakipsa jan wakiskiruw purintapxi. ukax markachirinakan chaqtawipa jan ukast maysa tuqunakar sarawip uñjasiraki.
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The question is often asked: what truly lies behind these major gains? Socioeconomic development has played a part.
Jiskt`awayaraktäna, kunapunis aka sarantawinakan utjpacha? markasawinakat suma sarantawipax sumakiw nayrar sarantayaski.
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The Commission on Social Determinants of Health set out three guiding principles through which to organize programmes of action to address the challenges and needs that it identified: • Improve the conditions of daily life – the circumstances in which people are born, grow, live, work, and age • Tackle the inequitable distribution of power, money, and resources – the structural drivers of those conditions of daily life – globally, nationally, and locally • Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is trained in the social determinants of health, and raise public awareness about the social determinants of health.
Uka Commission on Social Determinants of Health uksankirinakax kimsa wali wakiskir wakichäwinak uka amtanak phuqhañatakix ukhamarak munasirinakx uñjapxatayna: • Sapür jakañanak sumaptayaña - uka kunjamtix jaqinakax yuripk ukarjama, jilapki, jakapki, irnaqapki ukhamarak jiltapki • Uka kunjams yänakax lakirasiski uka apnaqañat sipansa, qullqit sipansa, ukhamarak yänak utjirinak sipansa - uka kunatix sapür jakañarux yanapkaspa - uraqpachana, markpachana, ukhamarak suyunakana • Ukhamarak uka jan walt’awinak uñakipaña, lurañanak uñjaña, yatiñanak ch’iqintayaña, ukhamarak irnaqawinakas k’umar jakañarux yanaparakikiwa, ukapachparak jaqirus amuyt’ayiwa.
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WHO had previously taken high-level strategic positions on the fundamental causes of poor health.
OMS ukankirinakax kunayman sartäwinak aka suma manq’anakataki jaqinakaru churaña.
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For example, Director-General Brundtland in the 1999 World Health Report estimated that around half the mortality reduction in the 30 years since 1960 in low-income and middle-income countries had been due to two main underlying influences: income and education.
Saraksnawa aka Brundtlan taqin tiricturapax aka 1999 uka maranxa yatiyapxataynawa chikatpachaw jani jiwarkataynati 30 maranakaw saraqatayna aka jakhunakaxa 1960 juk’ampi markanakan yatiqañanakampiw sartapxatayna.
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Nevertheless, much of the emphasis on solutions in the report was on strengthening health systems rather than broader-based initiatives in other sectors.
Jan ukasti, yaqha saririnakan jaqinakaw yatiyapxi ch’amanchasipxi qulla utjañataki yaqha siktranakata.
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In 2001, the Commission on Macroeconomics and Health, led by Professor Jeffrey Sachs, focused on the potential benefits to health of investment in areas such as education, sanitation, and water, and explored the relevance of poverty and the gains to health through tackling it.
2001 uka märanxa,jach’a Macro econimia ukat qullañanakampitwa Jeffrey Sachs, uka yatichirix aka qullxatanakpunrak yatintaski yatiqañatsa ikamaraki sumaptayarakiw umxa, ukhamarakiw suma yatxatatayna jan utjirinakatwa aka suma k’umarañanakapataki.
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The Commission on Social Determinants of Health has been one of the most important policy initiatives that WHO has launched in the last decade.
Comisionaxa aka kunjamsa sarnaqapaxa kunaymani markanakanxa aka qullanakantxa wali suma amtarakitaynawa pulitikanakatakixa aka tunka maranak saraqkipanxa.
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It has cascaded through the regional and country networks, not just as a technical reminder of the importance of health equity but as a transformative approach to thinking about the meaning of “health” itself, and how, in practical terms, to really address the root causes of poor health and social and economic disadvantage.
Aka ridis sat uka yatiyawinakaruw wali mistuskarakitayna janirakiw ma amtasiñakarakiti jan ukasti suma q’umara jakasiñataki uka uñtañataki jisa aka qullqi utjasinsa jan utjasinsa jaqinakarux ukas janirakiw walt’aykiti, jupanakan utjaspax ukhax alasipxaspaw suma ch’amanchir manq’anaksa, jan utjchix ukhax ukhamakï muturasipkija, ukatpi usuntañarusa puripxixa.
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Traditionally, although the global health community has recognized the wider and deeper influences on health in a diagnostic sense, action has tended to concentrate on the established risk factors (e.g.
Sarawipanakanxa aka qullir uksankirinakaxa aka uraqpachatwa wali uñjasipki kunanakapunisa jan walt’ayki uka tuqinakata,(sisnawa.
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smoking, physical inactivity, obesity, high blood pressure, unhealthy nutrition, excess alcohol intake).
tawakismu,jan inxtas qamaña, lik’intaña, walja wilani,jan suma manq’asisa,jaru umanak umantasisa).
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Social determinants have not been viewed as modifiable in the same way that these established risk factors are.
Aka sarawinakax janiw uñjaskiti jan ukasti akanakax ma jan walt’ayiri jasiñanakataki ukhamawa.
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Changes that go along with this have included improved female (and male) education, and falling fertility rates.
Aka mayxtawayanakampix sumakiw warmi chacha yatjatawinakapan apkatataski, ukxarus tasas de fertilidad uksa tuqitx apaqt`axarakiwa.
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However, the case studies in the Commission’s report, and the way in which many of WHO’s regions as well as national governments have constructed their own Marmot-style reviews and plans, has created a sense that practical action is not just feasible, not just necessary, but almost a moral imperative.
Jan ukasti, aka kast usunakat yatxatañax taqi markanakaruw puriwayi OMS ukas ukhamaraki ukat akaMarmot sat uñtañrak lurapxatayna, akham luranakax inawisax jan walichispa inawijax sumarakichispa ukhamawa.
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In 2011, the Brazil government and WHO convened an important meeting of Heads of Government, Ministers and government representatives, which issued the Rio Political Declaration on Social Determinants of Health.
2011 märanxa Brazil p’iqinchirinakapax OMS ukanakampix ma tantachäwi lurapxarakitayna ministrupanakampisa taqi p’iqicht’irinakampiw suma parlakipt’asin aka suma k’umar jakasiñataki.
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This included the clause: “We reaffirm that health inequities within and between countries are politically, socially and economically unacceptable, as well as unfair and largely avoidable, and that the promotion of health equity is essential to sustainable development and to a better quality of life and well-being for all, which in turn can contribute to peace and security”.
Akax ma tukt’awi: “aka usunak utjipanxa aka qullqi utjatapa jan utjatapa ukaru wakisi janiw askikiti ukanakxa jiwasaxax t’akhuysnawa suma qamañataki jani llakisiñataki aka usunak chhakhayañataki, suma qamasiñataki, suma manqt’asiña, suma, k’uchiki jakasiñataki.
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It is of particular importance that the orientation of the meeting was “political”.
Aka tantachawix aka “pulitik” uñtanipi tantachasiskarakix.
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This is where the commitment, ideas, and will needs to come from if the “causes of the causes” of ill health, premature mortality, and disability are to be really acted upon.
Ukatpi akhatrakpi suma sarantañaru amtasikarakispaxa aka usuntañanakxatsa walirakispawa ukanak sarantayañasa, wawat pach jiwañasa tukusirakispa.
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The fact that health is often determined in other sectors has become a recurrent topic in global policy fora.
Qumar jakasiñatakix yakha qutunakax aka politika ukarukipi uñtasipkarakixa, ukahmaraki yakha anqa uraqinakansa ukhamkrak lup’isipkaraki, uka amtani.
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It was clearly understood and expressed by the Heads of Government at this meeting.
Suma qatuqataw aka amtawinakax taqi p’iqi irpir gobiernonakatakixa.
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The Rio Political Declaration established five action areas, to: 1.
Política de rio satarux, phisqa tamanakarakiw jikthaptasipki: 1.
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adopt better governance for health and development 2.
Uywthapisiñ suma p’iqichirinak aka q’umar jakasiñataki usunak qullañanakataki, sarantayaña. 2.
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promote participation in policy-making and implementation 3.
Rarantaña ,irptaña uka politicampi aka amuyunak usk’tatanaka 3.
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Effective health interventions delivered successfully on a greater scale (particularly anti-retroviral drugs, insecticide-impregnated bed nets, measles vaccines) have also made an impact.
Tuqut yänakamp (qullanaka, antirretrovirales, mosqueteros ukhamas Sarampeon qulla usutaki) kust’atakirakiw markachirinakar Yanapt’apxaraki.
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further reorient the health sector towards reducing health inequities 4.
Uñichjatayañaw suma q’umar jakasiñanakapataki , juk’aptayañaw aka usunakaxa 4.
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strengthen global governance and collaboration 5.
Chamanchañaw taqpach uraqin p’iqichirinakaru ukhamarusa yanapt’añasawa 5.
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monitor progress and increase accountability Continuing to have a laser focus on the social determinants of health is one of the most important roles of WHO in the future.
Uñch’ukiñasaw aka sartäwinak juk’am jilxaptañapataki aka auma q’umar jakasiñataki jan usunakampi jiwaña ukaw wali suyañasa, OMS sarantaskakiñapawa.
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This is not simply to ensure that the many inequities in health are matched with practical programmes of action but to act as a custodian of a philosophy of public health that is broad-based, inter-disciplinary, and multi-sectoral.
Akax jani ñäpun jasakikaniti, kunayman suyt’awinakax kuna qakanakas utjapuniniw thakhinxa, jan ukasti luratanakampix satantaskakiñapawa. Aka taqi jaqinakatakixa rartaskakiñapaw aka kas lup’iwinakaja suma yatiqt’asiskakiñapawa. Aka interdiciplinaria ukatq multidiciplinaria uka tuqirusa.
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The last decade has brought a broadening awareness of the social determinants of health, and the programs of action needed to address them.
Aka tunta märanak saraqkipanx apanitaw aka suma q’umar jakañataki wali llakthapitaw uka tuqit amtañaxa sartaskakiñapas jiwasanakatakixa.
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This will be critical in the era of sustainable development.
Akax “era de la sostenibilidad” uka sartañankarakiniwa.
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The Sustainable Development Goals’ promise of “leaving no-one behind” means that health is protected and promoted to fulfil potential in life, but also that targeting adverse social circumstances will enable attainment of the best possible health.
Aka uñtäwinakax sarantañanakax”janiw khitirus khiparu jaytañakiti” uka sañ munix qullanakax waliptayiwa, suma qamasiñataki, sumankañataki taqinimpisa. Taqinis suma q’umarañapataki.
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The numerical challenges of population ageing are formidable.
Jan chuymaniñatakix kuayman qullanakampiw qullasipxi , muspkayawa.
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In 40 years’ time, 80% of the world’s over-60s will be in low- and middle-income countries.
40 Märanxa, 80% 60 maran chuymaninakaw taqpach urakinx jani suma qullqi utjirinakaniti.
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They will number more than the entire population of high-income countries combined.
Aka markanakax walja qullqinipxaniwa.
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The balance between the impact of general development and the impact of specific interventions in the field of health can be debated, but ultimately both have been important.
Kunjamat markan sarawip thakinchataskchi ukhamas salud tuqit ch’amanchawip Arxatayatarakispawa, aka pä qhananchawix kust’ayataskarakiwa.
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In the same time frame, there will be 330 million people over 60 years in China and 200 million in India, and a quarter of the population of Latin America and the Caribbean will also be in this age group.
Uka pachpa maranakanxa, 330 patak patakaniw 60 maran chuymaninakax utjani China markanxa ukat 200 patak patakarakiw India markanxa utjani. America Latinampi Caribimpix uka kikiparaki.
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With the rise in life expectancy, attention in many parts of the world is increasingly being focused on the question of healthy life expectancy.
Uka amuyumpix, juk’amp jakañ utjatapx, taqi markanaknwa ukanakata lup’isipkaraki suma q’umar jakañataki.
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This varies greatly between and within countries.
Akax anqa markanakansa mankha markanakansa janiw kikipakiti, ch’ullstiwa.
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It is often assumed that because death rates are falling, levels of disease and disability are coming down too.
Ukatpi usunakasa saraqtaskarakixa jan suma k’umar jaqinakasa janiw waljaxi ti.
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Some have asserted that this is not the case, saying that those countries that have experienced gains in life expectancy will find that the extra years are marked by ill-health and disability.
Yaqhipanakax janiw ukax ukhamakit sapxataynawa, kawknir markanakantix uka jakañax wali jaya maranakakixa ukanakanx yaqha maranakamp jilxattayapxatayna uka usunaktuqi ukhamarak discapacidadtuqi.
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The reality is that no one really knows for certain, though figures are regularly quoted.
Ukhamaw chiqaw janiw yatiskitis sumpunxa, aka yatxatatanakakiw uñist’ayistu.
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Routinely available information on healthy life expectancy is scarce and very inadequate.
Yatiyawinakax sapurpachaw arsutaskaraki suma q’umara jakañataki uñakipatjamax juk’akjamawa jan kuna luratjamawa.
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Discussing the quality of information may seem a technical argument.
Phiñasiñax aka yatiyawinakatxa janiw walikaspati tiknikur uñtatakaspasa ukhamaspawa.
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It is not.
Janisa.
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It will not be possible to plan properly for the impact of population ageing, nor evaluate public health programmes aimed at healthy ageing, without comprehensive valid measurement of health and functioning in older populations.
Janiw aka chumstaña ukanakax suma uñakipakiti janirakiwa yant’atakarakisa taki jakir jaqinakatakixa aka yatintañanakax aka chuyman jaqinakajapkix ukanakatakiwa.
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As childhood mortality has fallen, so the global health spotlight has fallen on the causes of premature death that come later in life.
Wawanakan jiwirinakat niyarakiw apaqt’at uñjaskaraki, ukarux “salud mundial” uksa tuqutx narxt’at jiwat uñstatanak ukaruw nayraqat sarantayataskaraki.
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There is also disagreement amongst experts on the choice of methods.
Utjiw jan may amuyux kust’atanakanxa janirakiw uka amuyunakaru arxatapkiti.
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For example, measures based on the presence, or absence, of disease do not take account of the fact that some older people experience much more disability from them than others.
Ukhamarakiw aka uñt’atanakax chhaqtata ukankir usunakatakisa jilir chuyman jaqinakax janiw amuyasipkiti kaniw walt’apkiti janchipanakanxa yakha jaqinakat sipansa.
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Also, the presence of multi-morbidity complicates the construction of metrics.
Jan ukasti, chamaspawa yatxataña aka usunakata yatxataña kunatix pachaw jani walt’aykarakispati.
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Simple measures of functioning in which older people are asked about or assessed for their ability to carry out activities of daily living, are easily understood.
Jasa sartawinakampix chuyman jaqinakarux jan walt’awipanakampix aka sapur jakañapampix yatsnawa.
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However, it can be difficult to determine whether the deficit is the individual or the environmental circumstances.
Jan ukasti ,chamaspawa yatxataña aka usunakata yatxataña kunatix pachaw jani walt’aykarakispati.
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For instance, someone might declare that they have difficulty in shopping for food because their walking is impaired or because there are no neighbourhood shops, so that the problem is access rather than loss of capacity.
Ukamaw yakhipax sarakispawa janiw manq’a alasiñ atkarakispati kunatix uka jaqix janiw sartaña atkiti, jan ukasti alasiña utanakaw jani utjkaspa ukhamapi ukapi jan walikaspaxa ukarukiwa jucha jaqutaspaja janirakipi jan wali ustut jaqirux jucha jaqutakaspatixa.
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To address these uncertainties in characterizing health in older age, WHO has adopted the concept of functional ability: “The health-related attributes that enable people to be and to do what they have reason to value; it is made up of the intrinsic capacity of the individual, relevant environmental characteristics and the interactions between the individual and these characteristics.” As people, and populations, age, the proportion of years spent in a state of health and vitality is of major significance.
Aka yatiñanakatakix jikt’awinakax aqa chuymani usuntañatakix, OMS qatuqataynaw :” aka q’umarañataki ukanakax jaqinakarux ukamañataki, lurañataki kunatima amuyuru suma; jaqinakaruw lup’iyi” Markanchiribnakax kurawesutiw chuymani tukxapxi ukhaxa usunakasa walrak ususntañ usuntañakiw purisxi, ukatpi suma q’umara ukharu puriñatakix wali imputantix.
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It has implications for quality of life of the individual, the level of social support required, and for families.
Suma qamañapatakwa pintix q’umara jakasiñapatakix kunjamas wila masinakampampi jakasipxi ukatwa.
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Most importantly, it has a great relevance to the need and demand for healthcare.
Wali impurtantiw, uka khansatayañaxa usunaka qullañ utanakaru suma qullatañapatäki.
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Many discussions about the future of healthcare start gloomily with a consideration of the growing numbers of old and very old people, with multiple chronic diseases, who are spoken of as a burden.
Walja arsuwinakaw akat khiparux suma qullasiñxata aka chuymani jaqinakatakija jan walt’ayir jiwayir usunakaw usuntayi ukhamarakiw ma qipikaspasa ukham uñjatakixiwa.
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Over the last decade, progress has been made in preventing and treating noncommunicable disease.
Aka tunka marat saraqawayatapatx jan usu katuñatak ukhamas jan usunak maynir apkatañatak apnaqataxarakiwa.
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This is misleading.
Akax jan chiqjamakiwa.
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The facts do not bear out assumptions that older people are largely dependent and unproductive.
Luratanakaw khanañchayi aka yatinaka chuymaninaka jan kunsa lurxapxiti ni irnaqxapxarakisa.
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On a world view, and also within countries and regions, this population is hugely diverse in its state of health, its outlook and attitudes, as well as its relationship with work, family life and civil society more generally.
Uraqpachan mä uñtawiw ,ukat jisk’a jacha markana ,anqa markanakan, aka usunak jarq’aqasiña uñjata. Kunjama irnakañanakampi, wila masinakapampisa , jaqi masinakapampisa, taqpachampi.
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Older people become involved in the societies that they live in through a wide range of forms of participation, including as: mentors, caregivers, artists, consumers, innovators, entrepreneurs and members of the workforce.
Chuyman jaqinakax mitispxiw jaqi taypirux jakawinakaparu, kunaymaninakata jupanakax lurapxi, yatichapxi, uñjiripxi, artistanakampxi, maq’iripxi, sarantayapxiri, imprisariunaka, irnaqañanakan ch’amanchirinaka.
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These roles can themselves promote older people’s health and well-being.
Aka sartanakax chuymani jaqinakarux walichaspawa q’umarañpataki, suma qamañapataki.
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Low- and middle-income countries have become used to being characterized by their youthful populations, but these are the very groups who will be ageing.
Pisinkir markamnakarusa, taypi suma jakasir markankirinakasa yatitapxiwa wayanakampi irnaqaña, jan ukasti aka waynanakaxa chumaniptapxarakiniwa.
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If present levels of resources and disease patterns persist, higher levels of poverty will make ageing in low- and middle-income countries more complex.
Ukhamtima lup’isipkanixa aka usunakaxa jiwasmpikipuniskaspawa ch’amankipuniw sartataspa.
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So too will: weak health systems; the greater threat of serious communicable and parasitic diseases; vulnerability to natural disasters; extreme weather events; and regional conflicts that displace populations.
Usu qullirinakax wali thukhaspawa; wiykati usunakasa, laqu usut sartirinakasa; aka pacha jan walt’ayirinakasa janiw walt’aykarakispati ukatsa, markanakan jan walt’yasitapasa ukaruwa ñanqhachaspa.
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Older people will be at additional jeopardy because of these influences.
Chuymani jaqinakaxa, uka jan walt’ayirinakampixa jiwarapxaspawa.
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The policy response to these challenges has developed slowly over the past decade as heads of state and health ministers have realized that the rapid population ageing that their countries are experiencing will have a major impact on all aspects of their societies.
Pulitik amtanak sartayañatakix wali k’achakiw aka tunka qhipa maranakanx sartaniwayi, uka kuwirnun p’iqiñchirinakjamax ukhamarak qullan kamanjamax uka jaqinakax markanakanx jank’akipuniw chuymarnuqstapxatayna, ukax markarux kunaymanat mayjt’ayani.