Use of Motion Pictures in Laboratory Dynamical Studies

In student laboratory experiments in dynamics, as, for example, Newton\u27s second law of motion or the conservation of momentum, it is, of course, highly desirable to allow motion with the least possible constraint and to observe the displacements of moving parts without using perturbing markers. This circumstance has led us to use motion pictures in the student laboratory for quantitative observation of rapid dynamic processes, a technique which is used in a well-known textbook.\u27 The photographic method combines maximum freedom of movement with accurate observation of position as a function of time, if the camera frame speed is sufficiently high. A double pendulum apparatus, with which we have studied the conservation of momentum in the student laboratory, is shown in Fig. 1. It consists of two wooden blocks, each suspended by a steel rod from a common free-swing pivot and counter-weighted in such a way that the center of mass of each pendulum is at the center of its wooden block. A spring is compressed between the two blocks, and they are tied together with a thread. When this thread is burned, the pendulums recoil. The mass of each block can be varied at will. The motion is photographed with a motion picture camera at 64 frames per second. The camera used in this work was a war-surplus gun-point aiming camera, adapted only to the extent of adding a viewfinder. Since there is a coordinate screen behind the pendulums, the student can determine the heights to which the blocks rise by examining the film with a magnifying viewer

Use of Motion Pictures in Laboratory Dynamical Studies

In student laboratory experiments in dynamics, as, for example, Newton\u27s second law of motion or the conservation of momentum, it is, of course, highly desirable to allow motion with the least possible constraint and to observe the displacements of moving parts without using perturbing markers. This circumstance has led us to use motion pictures in the student laboratory for quantitative observation of rapid dynamic processes, a technique which is used in a well-known textbook.\u27 The photographic method combines maximum freedom of movement with accurate observation of position as a function of time, if the camera frame speed is sufficiently high. A double pendulum apparatus, with which we have studied the conservation of momentum in the student laboratory, is shown in Fig. 1. It consists of two wooden blocks, each suspended by a steel rod from a common free-swing pivot and counter-weighted in such a way that the center of mass of each pendulum is at the center of its wooden block. A spring is compressed between the two blocks, and they are tied together with a thread. When this thread is burned, the pendulums recoil. The mass of each block can be varied at will. The motion is photographed with a motion picture camera at 64 frames per second. The camera used in this work was a war-surplus gun-point aiming camera, adapted only to the extent of adding a viewfinder. Since there is a coordinate screen behind the pendulums, the student can determine the heights to which the blocks rise by examining the film with a magnifying viewer

A Systematic Literature Review with Meta-Analyses of Within- and Between-Day Differences in Objectively Measured Physical Activity in School-Aged Children

Background: Targeting specific time periods of the day or week may enhance physical activity (PA) interventions in youth. The most prudent time segments to target are currently unclear.  Objectives: To systematically review the literature describing differences in young people’s objectively measured PA on weekdays vs. weekends, in school vs. out of school, weekends vs. out of school and lesson time vs. break time.  Methods: Electronic databases were searched for English-language, cross-sectional studies of school-aged children (4–18 years) reporting time-segment-specific accelerometer-measured PA from 01/1990 to 01/2013. We meta-analysed standardised mean differences (SMD) between time segments for mean accelerometer counts per minute (TPA) and minutes in moderate-to-vigorous PA (MVPA). SMD is reported in units of standard deviation; 0.2, 0.5 and 0.8 represent small, moderate and large effects. Heterogeneity was explored using meta-regression (potential effect modifiers: age, sex and study setting).  Results: Of the 54 included studies, 37 were eligible for meta-analyses. Children were more active on weekdays than weekends [pooled SMD (95 % CI) TPA 0.14 (0.08; 0.20), MVPA 0.42 (0.35; 0.49)]. On school days, TPA was lower in school than out of school; however, marginally more MVPA was accumulated in school [TPA −0.24 (−0.40; −0.08), MVPA 0.17 (−0.03; 0.38)]. TPA was slightly lower on weekends than out of school on school days, but a greater absolute volume of MVPA was performed on weekends [TPA −0.10 (−0.19; −0.01), MVPA 1.02 (0.82; 1.23)]. Heterogeneity between studies was high (I2 73.3–96.3 %), with 20.3–53.1 % of variance between studies attributable to potential moderating factors.  Conclusions: School-aged children are more active on weekdays than weekend days. The outcome measure influences the conclusions for other comparisons. Findings support the tailoring of intervention strategies to specific time periods

Future and potential spending on health 2015-40 : development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

Background The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. Methods We extracted GDP, government spending in 184 countries from 1980-2015, and health spend data from 1995-2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted. Findings We estimated that global spending on health will increase from US$9.21 trillion in 2014 to$24.24 trillion (uncertainty interval [UI] 20.47-29.72) in 2040. We expect per capita health spending to increase fastest in upper-middle-income countries, at 5.3% (UI 4.1-6.8) per year. This growth is driven by continued growth in GDP, government spending, and government health spending. Lower-middle income countries are expected to grow at 4.2% (3.8-4.9). High-income countries are expected to grow at 2.1% (UI 1.8-2.4) and low-income countries are expected to grow at 1.8% (1.0-2.8). Despite this growth, health spending per capita in low-income countries is expected to remain low, at $154 (UI 133-181) per capita in 2030 and$195 (157-258) per capita in 2040. Increases in national health spending to reach the level of the countries who spend the most on health, relative to their level of economic development, would mean $321 (157-258) per capita was available for health in 2040 in low-income countries. Interpretation Health spending is associated with economic development but past trends and relationships suggest that spending will remain variable, and low in some low-resource settings. Policy change could lead to increased health spending, although for the poorest countries external support might remain essential.Peer reviewe

Thick target preparation and isolation of 186Re from high current production via the 186W(d,2n)186Re reaction

Rhenium-186 has a half-life (t1/2 = 3.72 days) and emission of both gamma and beta particles that make it very attractive for use as a theranostic agent in targeted radionuclide therapy. 186Re can be readily prepared by the 185Re(n,γ)186Re reac-tion1. However, that reaction results in low specific activity, severely limiting the use of reactor produced 186Re in radiopharmaceuticals. It has previously been shown that high specific activity 186Re can be produced by cyclotron irradiations of 186W with protons and deuterons2,3. In this investigation we evaluated the 186W(d,2n)186Re reaction using thick target irradiations at higher incident deuteron energies and beam currents than previously reported. We elected not to use copper or aluminum foils in the preparation of our 186W targets due to their activation in the deuteron beam, so part of the investigation was an evaluation of an alternate method for preparing thick targets that withstand μA beam currents. Irradiation of 186W. Initial thick targets (~600-1100 mg) were prepared using 96.86% enriched 186W by hydraulic pressing (6.9 MPa) of tungsten metal powder into an aluminum target support. Those thick targets were irradiated for 10 minu-tes at 10 µA with nominal extracted deuteron energies of 15, 17, 20, 22, and 24 MeV. Isolation of 186Re. Irradiated targets were dissolved with H2O2 and basified with (NH4)2CO3 prior to separation using column(s) of ~100–300 mg Analig Tc-02 resin. Columns were washed with (NH4)2CO3 and the rhenium was eluted with ~80˚C H2O. Gamma-ray spectroscopy was per-formed to assess production yields, extraction yields, and radionuclidic byproducts. Recycling target material. When tested on a natural abundance W target, recovery of the oxidized WO4- target material from the resin was found to proceed rapidly with the addition of 4M HCl in the form of hydrated WO3. The excess water in the WO3 was then removed by calcination at 800 °C for 4 hours. This material was found to undergo reduction to metallic W at elevated temperatures (~1550 °C) in a tube furnace under an inert atmosphere (Ar). Quanti-fication of % reduction and composition analyses were accomplished with SEM, EDS, and XRD and were used to characterize and compare both the WO3 and reduced Wmetal products to a sample of commercially available material. Structural enhancement by surface annealing. In some experiments ~1 g WO3 pellets were prepared from Wmetal that had been chemically treated to simulate the target material recovery process described above. Following calcination, the WO3 was allowed to cool to ambient temperature, pulverized with a mortar and pestle and then uniaxially pressed at 13.8 MPa into 13 mm pellets. Conversion of the WO3 back to Wmetal in pellet form was accomplished in a tube furnace under flowing Ar at 1550 °C for 8 hours. Material characterization and product composition analyses were conducted with SEM, EDS, and XRD spectroscopy. Graphite-encased W targets. Irradiations were conducted at 20 μA with a nominal extracted deuteron energy of 17 MeV using thick targets (~750 mg) of natural abundance tungsten metal powder uniaxially pressed into an aluminum target support between layers of graphite pow-der (100 mg on top, 50 mg on the bottom). Targets were then dissolved as previously described and preliminary radiochemical isola-tion yields obtained by counting in a dose calibrator. Although irradiations of W targets were possible at 10 μA currents, difficulties were encountered in maintaining the structural integrity of the full-thickness pressed target pellets under higher beam currents. This led to further investigation of the target design for irradiations conducted at higher beam currents. Comprehensive target material characterization via analysis by SEM, EDS, XRD, and Raman Spectroscopy allowed for a complete redesign of the target maximizing the structural integrity of the pressed target pellet without impacting production or isolation. At the 10 A current, target mass loss following irradiation of an enriched 186W target was < 1 % and typical separation yields in excess of 70 % were observed. Saturated yields and percent of both 183Re (t½ = 70 days) and 184gRe (t½ = 35 days) relative to 186gRe (decay corrected to EOB) are reported in TABLE 1 below. The reason for the anomalously low yield at 24 MeV is unknown, but might be explained by poor beam alignment and/or rhenium volatility during irradiation. Under these irradiation conditions, recovery yields of the W target material from the recycling process were found to be in excess of 90% with no discernable differences noted when compared to commercially available Wmetal and WO3. Conceptually, increasing the structural integrity of pressed WO3 targets by high temperature heat treatment under an inert atmosphere is intriguing. However, the treated pellets lacked both density and structural stability resulting in disintegration upon manipulation , despite the initially encouraging energy dispersive X-ray spectroscopy (EDS) determination that 94.9% percent of the WO3 material in each pellet had been reduced to metallic W. The use of powdered graphite as a target stabi-lizing agent provided successful irradiation of natural abundance W under conditions where non-stabilized targets failed (20 µA at 17 MeV for 10 minutes). Target mass loss following irradiation of a natW target was < 1 % and a separation yield in excess of 97 % was obtained. In conclusion, the theranostic radionuclide 186Re was produced in thick targets via the 186W(d,2n) reaction. It was found that pressed W metal could be used for beam currents of 10 μA or less. For deuteron irradiations at higher beam currents, a method involving pressing W metal between two layers of graphite provides increased target stability. Both target configurations allow high recovery of radioactivity from the W target material, and a solid phase extraction method allows good recovery of 186Re. An effective approach to the recycling of enriched W has been developed using elevated temperature under an inert atmosphere. Further studies are underway with 186W targets sandwiched by graphite to assess 186Re production yields, levels of contaminant radiorhenium, power deposition, and enriched 186W material requirements under escalated irradiation conditions (20 µA and 17 MeV for up to 2 hours)

Targetry investigations of 186Re production via proton induced reactions on natural Osmium disulfide and Tungsten disulfide targets

Introduction Radioisotopes play an important role in nuclear medicine and represent powerful tools for imaging and therapy. With the extensive use of 99mTc-based imaging agents, therapeutic rhenium analogues are highly desirable. Rhenium-186 emits therapeutic − particles with an endpoint-energy of 1.07 MeV, allowing for a small, targeted tissue range of 3.6 mm. Additionally, its low abundance γ-ray emission of 137.2 keV (9.42 %) allows for in vivo tracking of a radiolabeled compounds and dosimetry calculations. With a longer half-life of 3.718 days, synthesis and shipment of Re-186 based radiopharmaceuticals is not limited. Rhenium-186 can be produced either in a reactor or in an accelerator. Currently, Re-186 is produced in a reactor via the 185Re(n,γ) reaction resulting in low specific activity which makes its therapeutic application limited.[1] Production in an accelerator, such as the PETtrace at the University of Missouri Research Reactor (MURR), can theoretically provide a specific activity of 34,600 Ci.mmol−1 Re[2], which represents a 62 fold increase over reactor produced 186Re. The studies reported herein focused on the evaluation of accelerator-based reaction pathways to produce high specific activity (HSA) 186Re. Those pathways include proton and deuteron bombardment of tungsten and osmium targets by the following reactions: 186W(p,n)186Re, 186W(d,2n) 186Re, 189Os(p,α)186Re, and 192Os(p,α3n)186Re. Additional information on target design related to the determination and optimization of production rates, radionuclidic purity, and yield are presented. Material and Methods Osmium and tungsten metals are very hard and thus very brittle. Attempts at pressing the pure metal into aluminum backings resulted in chalky targets, which easily crumbled during handling. Osmium disulfide (OsS2) and tungsten disulfide (WS2) were identified to provide a softer, less brittle chemical form for targets. OsS2 and WS2 targets were prepared using a unilateral press with a 13 mm diameter die to form pressed powder discs. A simple target holder design (FIG. 1) was implemented to provide a stabilizing platform for the pressed discs. The target material was sealed in place with epoxy using a thin aluminum foil pressed over the target face. Initial irradiations of OsS2 were performed using the 16 MeV GE PETtrace cyclotron at MURR. Irradiations were performed for 30–60 minutes with proton beam currents of 10–20 µA. Following irradiation, the OsS2 targets were dissolved in NaOCl and the pH adjusted using NaOH. The resultant aqueous solution was mixed with methyl ethyl ketone (MEK), with the lipophilic perrhenate being extracted into the MEK layer and the osmium and iridium remaining in the aqueous layer. The MEK extracts were then passed through an acidic alumina column to remove any remaining osmium and iridium. Determination of rhenium and iridium activities was done by gamma spectroscopy on an HPGe detector. Preliminary irradiations on WS2 targets were performed at MURR with the beam degraded to 14 MeV with a proton beam current of 10 µA for 60 minutes. After irradiation, WS2 was dissolved using 30% H2O2 with gentle heating and counted on an HPGe detector to determine the radio-nuclides produced. Results and Conclusion Thin natOsS2 targets were produced, irradiated at 16 MeV for 10 µAh, and analyzed for radiorhenium. Under these irradiation conditions, rhenium isotopes were produced in nanocurie quantities while iridium isotopes were produced in microcurie quantities. Future studies with higher proton energies are planned to increase the production of rhenium and decrease the production of iridium. After optimizing irradiation conditions, enriched 189Os will be used for irradiations to reduce the production of unwanted radionuclides. A liquid-liquid extraction method separated the bulk of the rhenium from the iridium. The majority of the rhenium produced was recovered in the first organic aliquot with little iridium observed while the majority of the iridium and osmium was retained in the first aqueous aliquot. Target production with WS2 was successful. A thin target of natWS2 was produced and irradiated at 14 MeV for 10 µAh. Under these irradiation conditions, several rhenium isotopes were produced in microcurie quantities. Target parameters to maximize 186Re production remain to be determined before enriched 186W targets are used for irradiations to reduce the production of unwanted radionuclides. In conclusion, the potential production routes for accelerator-produced high specific activity 186Re are being evaluated. Cyclotron-based irradiations of natOsS2 targets established the feasibility of producing rhenium via the natOs(p,αxn)Re reaction. Current results indicate higher proton energies are necessary to reduce the production of unwanted iridium isotopes while increasing the production of rhenium isotopes. Preliminary irradiations were performed using the 50.5 MeV Scanditronix MC50 clinical cyclotron at the University of Washington to determine irradiation parameters for future higher energy irradiations (20–30 MeV). A rapid liquid-liquid extraction method isolated rhenium from the bulk of the iridium and osmium following irradiation. Preliminary studies indicate WS2 may also provide a suitable target material to produce 186Re via the (p,n) reaction pathway

Hydrophilic and lipophilic radiopharmaceuticals as tracers in pharmaceutical development: In vitro – In vivo studies

BACKGROUND: Scintigraphic studies have been performed to assess the release, both in vitro and in vivo, of radiotracers from tablet formulations. Four different tracers with differing physicochemical characteristics have been evaluated to assess their suitability as models for drug delivery. METHODS: In-vitro disintegration and dissolution studies have been performed at pH 1, 4 and 7. In-vivo studies have been performed by scintigraphic imaging in healthy volunteers. Two hydrophilic tracers, ((99m)Tc-DTPA) and ((99m)Tc-MDP), and two lipophilic tracers, ((99m)Tc-ECD) and ((99m)Tc-MIBI), were used as drug models. RESULTS: Dissolution and disintegration profiles, differed depending on the drug model chosen. In vitro dissolution velocity constants indicated a probable retention of the radiotracer in the formulation. In vivo disintegration velocity constants showed important variability for each radiopharmaceutical. Pearson statistical test showed no correlation between in vitro drug release, and in vivo behaviour, for (99m)Tc-DTPA, (99m)Tc-ECD and (99m)Tc-MIBI. High correlation coefficients were found for (99m)Tc-MDP not only for in vitro dissolution and disintegration studies but also for in vivo scintigraphic studies. CONCLUSION: Scintigraphic studies have made a significant contribution to the development of drug delivery systems. It is essential, however, to choose the appropriate radiotracers as models of drug behaviour. This study has demonstrated significant differences in release patterns, depending on the model chosen. It is likely that each formulation would require the development of a specific model, rather than being able to use a generic drug model on the basis of its physicochemical characteristics

The state of health in the European Union (EU-27) in 2019: a systematic analysis for the Global Burden of Disease study 2019

Background: The European Union (EU) faces many health-related challenges. Burden of diseases information and the resulting trends over time are essential for health planning. This paper reports estimates of disease burden in the EU and individual 27 EU countries in 2019, and compares them with those in 2010. Methods: We used the Global Burden of Disease 2019 study estimates and 95% uncertainty intervals for the whole EU and each country to evaluate age-standardised death, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) rates for Level 2 causes, as well as life expectancy and healthy life expectancy (HALE). Results: In 2019, the age-standardised death and DALY rates in the EU were 465.8 deaths and 20,251.0 DALYs per 100,000 inhabitants, respectively. Between 2010 and 2019, there were significant decreases in age-standardised death and YLL rates across EU countries. However, YLD rates remained mainly unchanged. The largest decreases in age-standardised DALY rates were observed for “HIV/AIDS and sexually transmitted diseases” and “transport injuries” (each -19%). “Diabetes and kidney diseases” showed a significant increase for age-standardised DALY rates across the EU (3.5%). In addition, “mental disorders” showed an increasing age-standardised YLL rate (14.5%). Conclusions: There was a clear trend towards improvement in the overall health status of the EU but with differences between countries. EU health policymakers need to address the burden of diseases, paying specific attention to causes such as mental disorders. There are many opportunities for mutual learning among otherwise similar countries with different patterns of disease

Global, regional, and national prevalence of adult overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021

Background: Overweight and obesity is a global epidemic. Forecasting future trajectories of the epidemic is crucial for providing an evidence base for policy change. In this study, we examine the historical trends of the global, regional, and national prevalence of adult overweight and obesity from 1990 to 2021 and forecast the future trajectories to 2050. Methods: Leveraging established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the prevalence of overweight and obesity among individuals aged 25 years and older by age and sex for 204 countries and territories from 1990 to 2050. Retrospective and current prevalence trends were derived based on both self-reported and measured anthropometric data extracted from 1350 unique sources, which include survey microdata and reports, as well as published literature. Specific adjustment was applied to correct for self-report bias. Spatiotemporal Gaussian process regression models were used to synthesise data, leveraging both spatial and temporal correlation in epidemiological trends, to optimise the comparability of results across time and geographies. To generate forecast estimates, we used forecasts of the Socio-demographic Index and temporal correlation patterns presented as annualised rate of change to inform future trajectories. We considered a reference scenario assuming the continuation of historical trends. Findings: Rates of overweight and obesity increased at the global and regional levels, and in all nations, between 1990 and 2021. In 2021, an estimated 1·00 billion (95% uncertainty interval [UI] 0·989–1·01) adult males and 1·11 billion (1·10–1·12) adult females had overweight and obesity. China had the largest population of adults with overweight and obesity (402 million [397–407] individuals), followed by India (180 million [167–194]) and the USA (172 million [169–174]). The highest age-standardised prevalence of overweight and obesity was observed in countries in Oceania and north Africa and the Middle East, with many of these countries reporting prevalence of more than 80% in adults. Compared with 1990, the global prevalence of obesity had increased by 155·1% (149·8–160·3) in males and 104·9% (95% UI 100·9–108·8) in females. The most rapid rise in obesity prevalence was observed in the north Africa and the Middle East super-region, where age-standardised prevalence rates in males more than tripled and in females more than doubled. Assuming the continuation of historical trends, by 2050, we forecast that the total number of adults living with overweight and obesity will reach 3·80 billion (95% UI 3·39–4·04), over half of the likely global adult population at that time. While China, India, and the USA will continue to constitute a large proportion of the global population with overweight and obesity, the number in the sub-Saharan Africa super-region is forecasted to increase by 254·8% (234·4–269·5). In Nigeria specifically, the number of adults with overweight and obesity is forecasted to rise to 141 million (121–162) by 2050, making it the country with the fourth-largest population with overweight and obesity. Interpretation: No country to date has successfully curbed the rising rates of adult overweight and obesity. Without immediate and effective intervention, overweight and obesity will continue to increase globally. Particularly in Asia and Africa, driven by growing populations, the number of individuals with overweight and obesity is forecast to rise substantially. These regions will face a considerable increase in obesity-related disease burden. Merely acknowledging obesity as a global health issue would be negligent on the part of global health and public health practitioners; more aggressive and targeted measures are required to address this crisis, as obesity is one of the foremost avertible risks to health now and in the future and poses an unparalleled threat of premature disease and death at local, national, and global levels. Funding: Bill &amp; Melinda Gates Foundation

Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026

Background: The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods: In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings: In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95$7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95$43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and$37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation: There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained