Martin McKee

Maastricht University, Maestricht, Limburg, Netherlands

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Publications (765)6041.07 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Progressive realisation of Universal Health Coverage is a widely accepted goal for the post-2015 Millennium Development Goals. Yet the means to pay for it is a subject of intense debate. Method: Using cross-national fixed effects models,investigated how alternative tax systems affect health coverage and associated child and maternal health outcomes in 89 low- and middle-income countries from 1995-2011. Findings: We identified tax revenue as a major statistical determinant of progress towards Universal Health Coverage. Each $100 per capita per year of additional tax revenues corresponded to $9.86 yearly increase in government health spending (95% CI $3.92 to $15.8). This association was particularly strong for taxes on capital gains, profits and income ($16.7, 95% CI: $9.16 to $24.3). In countries with low tax revenues (<$1000 per capita per year), an additional $100 tax revenue per year substantially increased the extent of health coverage by 11.4 percentage points (95% CI 5.51 to 17.2). However, in contrast, $100 per capita increase in regressive forms of taxation, such as taxes on goods and services, which may reduce the ability of the poor to afford essential goods, was associated with higher rates of under five mortality rate by 0.43 per 100,000 population (95% CI: 0.14 to 0.72). Interpretation: Increasing domestic tax revenues is a key element of a strategy to achieving Universal Health Coverage. Pro-poor taxes on profits and capital gains appear to support expansion of health coverage without the adverse effects on health outcomes of higher taxes on goods and services.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: Background WHO stresses the need to act on the social determinants of tuberculosis. We tested whether alternative social protection programmes have affected tuberculosis case notifications, prevalence, and mortality, and case detection and treatment success rates in 21 European countries from 1995 to 2012. Methods We obtained tuberculosis case notification data from the European Centre for Disease Prevention and Control's 2014 European Surveillance System database. We also obtained data for case detection, treatment success, prevalence, and mortality rates from WHO's 2014 tuberculosis database. We extracted data for 21 countries between Jan 1, 1995, and Dec 31, 2012. Social protection data were from EuroStat, 2014 edition. We used multivariate cross-national statistical models to quantify the association of differing types of social protection programmes with tuberculosis outcomes. All analyses were prespecified. Findings After we controlled for economic output, public health spending, and country fixed effects, each US$100 increase in social protection spending was associated with a decrease per 100 000 population in the number of tuberculosis case notifications of −1·53% (95% CI −0·28 to −2·79; p=0·0191), estimated incidence rates of −1·70% (−0·30 to −3·11; p=0·0201), non-HIV-related tuberculosis mortality rate of −2·74% (−0·66 to −4·82; p=0·0125), and all-cause tuberculosis mortality rate of −3·08% (−0·73 to −5·43; p=0·0127). We noted no relation between increased social spending and tuberculosis prevalence (−1·50% [–3·10 to 0·10] per increase of $100; p=0·0639) or smear-positive treatment success rates (−0·079% [–0·18 to 0·34] per increase of $100; p=0·5235) or case detection (−0·59% [–1·31 to 0·14] per increase of $100; p=0·1066). Old age pension expenditure seemed to have the strongest association with reductions in tuberculosis case notification rates for those aged 65 years or older (−3·87% [–0·95 to −6·78]; p=0·0137). Interpretation Investment in social protection programmes are likely to provide an effective complement to tuberculosis prevention and treatment programmes, especially for vulnerable groups. Funding European Centre for Disease Prevention and Control.
    The Lancet. Infectious diseases. 10/2014;
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    ABSTRACT: During the 2007-11 recessions in Europe, suicide increases were concentrated in men. Substantial differences across countries and over time remain unexplained. We investigated whether increases in unaffordable housing, household indebtedness or job loss can account for these population differences, as well as potential mitigating effects of alternative forms of social protection.
    European journal of public health. 10/2014;
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    ABSTRACT: There remains limited evidence on comorbidity of mental disorders among conflict-affected civilians, particularly internally displaced persons (IDPs) and former IDPs who have returned to their home areas (returnees). The study aim was to compare patterns of mental disorders and their influence on disability between IDPs and returnees in the Republic of Georgia. A cross-sectional household survey was conducted with adult IDPs from the conflicts in the 1990s, the 2008 conflict, and returnees. Posttraumatic stress disorder (PTSD), depression, anxiety, and disability were measured using cut scores on Trauma Screening Questionnaire, Patient Health Questionnaire 9, Generalised Anxiety Disorder 7, and the WHO Disability Assessment Schedule 2.0. Among the 3,025 respondents, the probable prevalence of PTSD, depression, anxiety, and comorbidity (>1 condition) was 23.3%, 14.0%, 10.4%, 12.4%, respectively. Pearson correlation coefficients (p < .001) were .40 (PTSD with depression), .38 (PTSD with anxiety), and .52 (depression with anxiety). Characteristics associated with mental disorders in regression analyses included displacement (particularly longer-term), cumulative trauma exposure, female gender, older age, poor community conditions, and bad household economic situation; coefficients ranged from 1.50 to 3.79. PTSD, depression, anxiety, and comorbidity were associated with increases in disability of 6.4%, 9.7%, 6.3%, and 15.9%, respectively. A high burden of psychiatric symptoms and disability persist among conflict-affected persons in Georgia.ResumenContinúa existiendo limitada evidencia sobre la comorbilidad de los trastornos mentales entre civiles afectados por conflictos, particularmente personas desplazadas internamente y personas previamente desplazadas internamente que han regresado a sus áreas de origen (repatriados). El objetivo del estudio fue comparar patrones de trastornos mentales y su influencia en la discapacidad entre personas desplazadas internamente y repatriados en la República de Georgia. Se realizó un estudio transversal de encuestas domiciliarias con personas adultas internamente desplazadas en los conflictos de los años 90, el conflicto del 2008, y repatriados. Se evaluó Trastorno por Estrés Postraumático (TEPT), depresión, ansiedad, y discapacidad usando el Trauma Screening Questionnaire, Patient Health Questionnaire 9, Generalised Anxiety Disorder 7, y el WHO Disability Assessment Schedule 2.0. Entre los 3,025 encuestados, la prevalencia de TEPT, depresión, ansiedad y comorbilidad (>1 afección) fue 23.3%, 14.0%, 10.4%, 12.4% respectivamente. Los coeficientes de correlación de Pearson (p<.001) fueron .40 (TEPT con depresión), .38 (TEPT con ansiedad), .52 (depresión con ansiedad). Las características asociadas con trastornos mentales en los análisis de regresión incluyeron el desplazamiento (particularmente a más largo plazo), la exposición acumulativa a trauma, el género femenino, la edad avanzada, las pobres condiciones comunitarias y la mala situación económica del hogar. Los coeficientes oscilaron entre 1,50 y 3,79. TEPT, depresión, ansiedad y comorbilidad se asociaron a mayor discapacidad de 6%, 10%, 6% y 16%, respectivamente. Una alta carga de trastornos mentales y discapacidad persisten entre las personas afectadas por conflictos en Georgia.Traditional and Simplified Chinese Abstracts by AsianSTSS標題:格魯吉亞的內部流放人士和回流人士的精神病及其傷殘狀況撮要:我們只有少量研究關於受衝突影響的平民中精神病的共病性,尤其是那些內部流放人士或曾內部流放而重返家園的人士(即回流者)。本研究旨在對照格魯吉亞共和國內部流放人士和回流者的精神病模式,及其影響傷殘的狀況。研究是橫斷面設計,而樣本是在1990年代和2008年衝突中內部流放及回流的成人。我們使用創傷篩選問卷,病者健康問卷第九版,廣泛焦慮症第七版和WHO傷殘評估日程2.0來評斷創傷後壓力症(PTSD) 、抑鬱、焦慮和傷殘情況。在3,025名受訪者中,PTSD、抑鬱、焦慮和共病性(>一種病症)的流行率分別是23.3%,14.0%,10.4%和12.4%。Pearson相關系數(p <.001)是.40 (PTSD和抑鬱),.38(PTSD和焦慮), 及 .52 (抑鬱和焦慮)。回歸分析中與精神病相關特性包括:流放(特別是長期),累積創傷經歷、女性、年老、社區狀況不理想、和家庭經濟景況系數不良(從1.50至3.79)。PTSD、抑鬱、焦慮和共病狀況與傷殘加劇(分別是6%, 10%, 6%和16%) 相連。格魯吉亞受衝突影響人士中普遍存在精神病困擾和嚴重傷殘。标题:格鲁吉亚的内部流放人士和回流人士的精神病及其伤残状况撮要:我们只有少量研究关于受冲突影响的平民中精神病的共病性,尤其是那些内部流放人士或曾内部流放而重返家园的人士(即回流者)。本研究旨在对照格鲁吉亚共和国内部流放人士和回流者的精神病模式,及其影响伤残的状况。研究是横断面设计,而样本是在1990年代和2008年冲突中内部流放及回流的成人。我们使用创伤筛选问卷,病者健康问卷第九版,广泛焦虑症第七版和WHO伤残评估日程2.0来评断创伤后压力症(PTSD) 、抑郁、焦虑和伤残情况。在3,025名受访者中,PTSD、抑郁、焦虑和共病性(>一种病症)的流行率分别是23.3%,14.0%,10.4%和12.4%。Pearson相关系数(p <.001)是.40 (PTSD和抑郁),.38(PTSD和焦虑), 及 .52 (抑郁和焦虑)。回归分析中与精神病相关特性包括:流放(特别是长期),累积创伤经历、女性、年老、小区状况不理想、和家庭经济景况系数不良(从1.50至3.79)。PTSD、抑郁、焦虑和共病状况与伤残加剧(分别是6%, 10%, 6%和16%) 相连。格鲁吉亚受冲突影响人士中普遍存在精神病困扰和严重伤残。
    Journal of Traumatic Stress 10/2014; 27(5). · 2.72 Impact Factor
  • Journal of the Royal Society of Medicine 10/2014; 107(10):387-92. · 1.72 Impact Factor
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    Lancet. 09/2014;
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    ABSTRACT: Pharmaceutical costs dominate out-of-pocket payments in former Soviet countries, posing a severe threat to financial equity and access to health services. Nationally representative household survey data collected in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine were analysed to compare the level of population having to forego medicines in 2001 and 2010. Subgroup analysis was conducted to assess differences between populations of different economic status, and rural and urban populations. A substantial proportion of the population did forego medicines in 2010, from 29.2% in Belarus to 72.9% in Georgia. There was a decline in people foregoing medicines between 2001 and 2010; the greatest decline was seen in Moldova [rate ratio(RR) = 0.67(0.63;0.71)] and Kyrgyzstan [RR = 0.63(0.60;0.67)], while very little improvement took place in countries with a higher Gross National Income (GNI) per capita and greater GNI growth over the decade such as Armenia [RR = 0.92(0.87;0.96)] and Georgia [RR = 0.95(0.92;0.98)]. Wealthier, urban populations have benefitted more than poorer, rural households in some countries. Countries experiencing the greatest improvement over the study period were those that have implemented policies such as price controls, expanded benefits packages, and encouragement of rational prescribing. Greater commitment to pharmaceutical reform is needed to ensure that people are not forced to forego medicines.
    Health Policy 09/2014; · 1.51 Impact Factor
  • Journal of Renal Care 09/2014;
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    ABSTRACT: In this study we apply the principles of patient-centred care to assess how health systems in middle income countries shape the experiences of patients with a common chronic disease and their care providers. We conducted semi-structured interviews with patients with diabetes, health professionals and key informants. We selected interviewees by purposive and snowball sampling. In total 340 respondents were interviewed in five countries: Armenia, Belarus, Moldova, Russia and Ukraine. Data was analysed according to a coding framework that was developed by three researchers, who then uncovered salient themes, similarities and differences between the five countries. Access to and consistent use of services was hampered by the lack of coordination and the financial weaknesses in the health systems. In many cases, lack of external support for individual patients left friends and family as the main providers of support. Patients were not expected to have a say or challenge the decisions concerning their treatment. Our study suggests the need for a radically different way of delivering care for people with diabetes and, by extension, other chronic diseases. Reforms should focus on improving self-management, the coordination of care, involving patients in decisions about their care, and providing emotional and practical support for patients.
    Health Policy. 08/2014;
  • Journal of Public Health Policy 08/2014; 35(3). · 1.48 Impact Factor
  • Martin McKee
    International journal of public health. 08/2014;
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    ABSTRACT: The tobacco industry spends large sums lobbying the European Union (EU) institutions, yet whether such lobbying significantly affects tobacco policy is not well understood. We used novel quantitative text mining techniques to evaluate the impact of industry pressure on the contested EU Tobacco Products Directive revision.
    Tobacco control. 08/2014;
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    ABSTRACT: The European Union Directive on cross-border health care places an obligation on member states (MSs) to establish one or more national contact points (NCPs). We evaluated whether MSs were meeting their legal obligations. Two researchers created a set of criteria, drawn from the Directive, to evaluate the information that 18 MSs provide on their NCP websites. Some 15 of the 18 MSs evaluated provided >75% of the information sought. This report shows examples of best practices that could be used to encourage other MSs to improve the quality and quantity of information provided.
    European journal of public health. 08/2014;
  • Pascal Diethelm, Martin McKee
    Tobacco control. 07/2014;
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    ABSTRACT: AimsAlcohol can induce diverse serious pathologies yet this complexity may be obscured when alcohol-related deaths are classified according to a single underlying cause. We sought to quantify this issue and its implications for analysing mortality data.Design, settings and participantsCross-sectional study included 554 men aged 25-54 in Estonia undergoing forensic autopsy in 2008-9.MeasurementsPotentially alcohol-related pathologies were identified following macroscopic and histological examination. Alcohol biomarkers levels were determined. For a subset (∼30%), drinking behaviour was provided by next-of-kin. The Estonian Statistics Office provided underlying cause of death.FindingsMost deaths (∼75%) showed evidence of potentially alcohol-related pathologies, and 32% had pathologies in two or more organs. The liver was most commonly affected (61%, 95% CI 56-65) followed by the lungs (19%, 95% CI 15-22), stomach (18%, 95% CI 14-21), pancreas (14%, 95% CI 11-17), heart (5%, 95% CI 3-7) and oesophagus (1%, 95% CI 1-3). Only a minority with liver pathology had a second pathology. The number of pathologies correlated with alcohol biomarkers (phosphatidylethanol, gamma-glytamyl transpeptidase in blood, ethylglucuronide, ethylsulfate in urine). Despite the high prevalence of liver pathology few deaths had alcoholic liver disease specified as the underlying cause.Conclusion The majority of 554 men aged 25-54 undergoing forensic autopsy in Estonia in 2008-9 showed evidence of alcohol-related pathology. However, the recording of deaths by underlying cause failed to capture the scale and nature of alcohol-induced pathologies found.
    Addiction 07/2014; · 4.58 Impact Factor
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  • Aaron Reeves, Martin McKee, David Stuckler
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    ABSTRACT: There has been a substantial rise in 'economic suicides' in the Great Recessions afflicting Europe and North America. We estimate that the Great Recession is associated with at least 10 000 additional economic suicides between 2008 and 2010. A critical question for policy and psychiatric practice is whether these suicide rises are inevitable. Marked cross-national variations in suicides in the recession offer one clue that they are potentially avoidable. Job loss, debt and foreclosure increase risks of suicidal thinking. A range of interventions, from upstream return-to-work programmes through to antidepressant prescriptions may help mitigate suicide risk during economic downturn.
    The British journal of psychiatry: the journal of mental science 06/2014; · 6.62 Impact Factor
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    ABSTRACT: Introduction: The political drive for cross border care within the European Union (EU) and an increasing focus on integrated care both have implications for Electronic Health Records (EHRs). The hospital discharge summary is a critical component of systems to ensure quality and continuity of care and in a cross-border setting would particularly benefit from an electronic version. We have explored the extent to which EU level policy and practice on EHRs address issues pertinent to the development and implementation of electronic discharge summaries for patients treated outside their own country. Methods: We approached the topic by analysing data from two different sources: EU policy documents on topics relevant to EHRs, and deliverables of EU-funded EHR-focused research and development projects. Elements pertinent to different aspects of interoperability – legal, semantic and technical- were extracted from both sources and their content compared to assess the degree of consistency between policy and implementation targets. Results: We identified 25 policy documents and 14 EU-funded projects. Our results show that European legislation is increasingly aligned with projects funded through EU sources and substantial progress has been accomplished in achieving electronic communication across European health systems. Nevertheless, the achievement of a European level interoperable discharge summary is still a distant goal, while inadequate attention has been paid to the coordination of current discharge summary practices in Member States. Discussion: If the harmonized EU patient summary is also to function as an electronic discharge summary, further specific steps are needed that address issues of both content and processes related to communication.
    International Journal of Care Coordination. 06/2014;
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    ABSTRACT: Existing research suggests that care pathways can improve the quality, organisation and consistency of care. However, little is known about the current scope and implementation of care pathways across the world. In collaboration with the European Pathway Association (E-P-A), we designed and implemented a survey on the use of care pathways. The survey could not be representative of national experience with care pathways, given that they are most often developed locally, but rather aimed to provide insight into differences and commonalities. We collected 163 responses (25% response rate) from 39 countries across the world. The survey uncovered variability in the use of evidence-based guidelines, a continued reliance on giving patients information rather than investing in self-management training, suboptimal involvement of patients in the development of, and training on, care pathways, and reported challenges of evaluating the effectiveness of care pathways against a range of indicators. More work is needed to understand the care pathways that are in place, how they compare , and what would need to be done to make them mutually compatible.
    Journal of Care Services Management. 06/2014;
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    ABSTRACT: The current proposals to update the European Union (EU) directive on professional qualifications will have potentially important implications for health professions. Yet those discussing it will struggle to find basic information on key issues such as licensing and registration of physicians in different countries. A survey was conducted among national experts in 14 EU member states, supplemented by literature and independent expert review. The questionnaire covered five components of licensing and registration: (1) definitions, (2) regulatory basis, (3) governance, (4) the process of registration and (5) flow and quantity of applications. We identify seven areas of concern: (1) the meaning of terminology, which is inconsistent; (2) the role of language assessments and the responsibility for them; (3) whether approval to practise should be lifelong or time limited, subject to periodic assessment; (4) the need for improved systems to identify those deemed no longer fit to practise in one member state; (5) the complexity of processes for graduates from non-EU/European Economic Area (EAA) countries; (6) public access to registers; and (7) transparency of systems of governance. The systems of licensing and registration of doctors in Europe have developed within specific national contexts and vary widely. This creates inevitable problems in the context of free movement of professionals and increasing mobility.
    Clinical medicine (London, England) 06/2014; 14(3):229-38. · 1.32 Impact Factor

Publication Stats

11k Citations
6,041.07 Total Impact Points


  • 2014
    • Maastricht University
      • Department of Health Services Research
      Maestricht, Limburg, Netherlands
  • 1991–2014
    • London School of Hygiene and Tropical Medicine
      • • European Centre on Health of Societies in Transition
      • • Department of Health Services Research and Policy
      Londinium, England, United Kingdom
  • 2013
    • University of Southampton
      • Division of Economics
      Southampton, ENG, United Kingdom
    • The University of Edinburgh
      Edinburgh, Scotland, United Kingdom
    • University of Michigan
      Ann Arbor, Michigan, United States
    • Erasmus Universiteit Rotterdam
      • Department of Public Health (MGZ)
      Rotterdam, South Holland, Netherlands
    • University of Auckland
      Окленд, Auckland, New Zealand
    • University of East Anglia
      • Norwich Medical School
      Norwich, ENG, United Kingdom
    • New York University Abu Dhabi
      Dubayy, Dubai, United Arab Emirates
    • California Pacific Medical Center Research Institute
      San Francisco, California, United States
    • University of Pennsylvania
      Philadelphia, Pennsylvania, United States
  • 2012–2013
    • Royal Observatory of Belgium
      Bruxelles, Brussels Capital Region, Belgium
    • Harvard University
      • • Department of Global Health and Population
      • • Department of Health Policy and Management
      Boston, MA, United States
    • Erasmus MC
      • Research Group for Public Health
      Rotterdam, South Holland, Netherlands
    • Stanford University
      • Stanford Prevention Research Center
      Palo Alto, CA, United States
    • Open Society Foundations
      New York City, New York, United States
    • Universiteit Utrecht
      • Faculty of Social and Behavioural Sciences
      Utrecht, Provincie Utrecht, Netherlands
    • University of the Balearic Islands
      Palma, Balearic Islands, Spain
    • UK Department of Health
      Londinium, England, United Kingdom
    • University of Liverpool
      • Department of Public Health and Policy
      Liverpool, ENG, United Kingdom
    • IT University of Copenhagen
      København, Capital Region, Denmark
    • University of Leicester
      • Department of Health Sciences
      Leicester, ENG, United Kingdom
  • 2009–2013
    • Hamilton Health Sciences
      Hamilton, Ontario, Canada
    • European Commission - Joint Research Centre
      • Econometrics and Applied Statistics Unit
      Brussels, BRU, Italy
  • 2008–2013
    • University of Oxford
      • Department of Sociology
      Oxford, ENG, United Kingdom
    • University of Cambridge
      • Department of Sociology
      Cambridge, ENG, United Kingdom
    • Moscow Institute of Open Education
      Moskva, Moscow, Russia
    • Inštitut za vode Republike Slovenije
      Lubliano, Ljubljana, Slovenia
  • 2007–2013
    • Södertörn University
      Huddinge, Stockholm, Sweden
    • World Bank
      Washington, Washington, D.C., United States
  • 2001–2013
    • The London School of Economics and Political Science
      • Department of Social Policy
      Londinium, England, United Kingdom
    • The University of Georgia (Tbilisi)
      Tbilsi, T'bilisi, Georgia
    • Hochschule für Angewandte Wissenschaften Hamburg
      Hamburg, Hamburg, Germany
    • University of São Paulo
      • Departamento de Economia, Administração e Sociologia (LES) (ESALQ)
      Ribeirão Preto, Estado de Sao Paulo, Brazil
  • 1999–2013
    • University College London
      • • Department of Applied Health Research
      • • Department of Epidemiology and Public Health
      • • Department of Infection and Population Health
      • • Institute for Global Health (IGH)
      Londinium, England, United Kingdom
  • 1995–2013
    • University of Debrecen
      • • Department of Preventive Medicine (Faculty of Medicine)
      • • Medical and Health Science Centre
      • • Department of Preventive Medicine (Faculty of Public Health)
      • • Division of Public Health Medicine
      Debrecen, Hajdu-Bihar, Hungary
  • 2011–2012
    • McMaster University
      • Population Health Research Institute (PHRI)
      Hamilton, Ontario, Canada
    • University of Queensland 
      • UQ Centre for Clinical Research
      Brisbane, Queensland, Australia
    • RAND Corporation
      Santa Monica, California, United States
    • The Whittington Hospital NHS Trust
      Londinium, England, United Kingdom
    • National Research University Higher School of Economics
      Moskva, Moscow, Russia
    • San Francisco VA Medical Center
      San Francisco, California, United States
  • 2010–2012
    • University of Ottawa
      • Institute of Population Health
      Ottawa, Ontario, Canada
    • University of Rochester
      • Department of Community and Preventive Medicine
      Rochester, NY, United States
    • National Health Research Institutes
      Miao-li-chieh, Taiwan, Taiwan
    • Curatio International Foundation
      Tbilsi, T'bilisi, Georgia
  • 2009–2012
    • Università degli Studi di Siena
      Siena, Tuscany, Italy
  • 2006–2012
    • University of Tartu
      • Department of Public Health (ARTH)
      Tartu, Tartumaa, Estonia
    • Royal Free London NHS Foundation Trust
      Londinium, England, United Kingdom
  • 2005–2012
    • Imperial College London
      • Centre for Mental Health
      Londinium, England, United Kingdom
    • Izhevsk State Medical Academy
      Ishewsk, Udmurtiya, Russia
  • 2009–2011
    • University of Bath
      • Department for Health
      Bath, England, United Kingdom
  • 1999–2010
    • Russian Academy of Sciences
      Moskva, Moscow, Russia
  • 2001–2009
    • Max Planck Institute for Demographic Research
      • Laboratory of Demographic Data
      Rostock, Mecklenburg-Vorpommern, Germany
  • 2004–2007
    • World Health Organization WHO
      Islāmābād, Islāmābād, Pakistan
    • Tallinn University of Technology
      Kolyvan, Harju, Estonia
  • 1999–2006
    • University of London
      • The London School of Hygiene and Tropical Medicine
      Londinium, England, United Kingdom
  • 2004–2005
    • Semmelweis University
      • Health Services Management Training Centre
      Budapest, Budapest fovaros, Hungary
  • 2002
    • Carol Davila University of Medicine and Pharmacy
      Bucureşti, Bucureşti, Romania
  • 2000
    • Saint Joseph Health System London
      Londinium, England, United Kingdom
  • 1998
    • Policy Studies Institute
      Londinium, England, United Kingdom
  • 1993
    • Bundesministerium für Arbeit und Soziales
      Berlín, Berlin, Germany