ubled the rate of premature death (ie, before age 70 years). If this 2-fold mortality RR continues into old age, about half of participants who start smoking before age 15 years and do not stop will eventually die of complications from their habit. The greatest risks were found among adults who began smoking before age 10 years. Funding UK Medical Research Council, Cancer Research UK, British Heart Foundation, US Centers for Disease Control and Prevention (CDC) Foundation (with support from Amgen).Background Multimorbidity, the presence of two or more mental or physical chronic non-communicable diseases, is a major challenge for the health system in China, which faces unprecedented ageing of its population. Here we examined the distribution of physical multimorbidity in relation to socioeconomic status; the association between physical multimorbidity, health-care service use, and catastrophic health expenditures; and whether these associations varied by socioeconomic group and social health insurance schemes. Methods In this population-based, panel data analysis, we used data from three waves of the nationally representative China Health and Retirement Longitudinal Study (CHARLS) for 2011, 2013, and 2015. We included participants aged 50 years and older in 2015, who had complete follow-up for the three waves. We used 11 physical non-communicable diseases to measure physical multimorbidity and annual per-capita household consumption spending as a proxy for socioeconomic status. Findings Of 17 708 particferent social health insurance programmes. Overall, physical multimorbidity was associated with a significantly increased likelihood of catastrophic health expenditure (for the overall population odds ratio 1·29, 95% CI 1·26-1·32, adjusted for sociodemographic variables). The effect of physical multimorbidity on catastrophic health expenditures persisted even among the higher socioeconomic groups and across all health insurance programmes. Interpretation Concerted efforts are needed to reduce health inequalities that are due to physical multimorbidity, and its adverse economic effect in population groups in China. Social health insurance reforms must place emphasis on reducing out-of-pocket spending for patients with multimorbidity to provide greater financial risk protection. Funding None.Background Disease Control Priorities, 3rd edition (DCP3), published two model health benefits packages (HBPs). This study estimates the overall costs and individual component costs of these packages in low-income countries (LICs) and lower-middle-income countries (lower-MICs). Methods This study reports on our Disease Control Priorities Cost Model (DCP-CM), developed as part of the DCP3 project to determine the overall costs of the 218 health sector interventions recommended in the model HBP termed essential universal health coverage (EUHC). Model inputs included data on intervention unit costs, demographic and epidemiological data to quantify the populations in need of specific interventions, baseline coverage indicators, and estimates of required health system costs to support direct service delivery. The DCP-CM was informed primarily by published estimates of economic costs of interventions measured from the health system perspective. We estimated counterfactual annual costs for the year 2015. We disaggre-37·9] in LICs and 43·0% [42·6-43·4] in lower-MICs). Interventions addressing chronic health conditions (requiring 45·5% [44·8-46·4] 2015 GNI for LICs and lower-MICs combined) and interventions delivered in health centres (requiring 49·8% [49·5-50·2] 2015 GNI for LICs and lower-MICs combined) would each comprise the plurality of costs. Interpretation Implementation of EUHC would require costly investment, especially in LICs. DCP-CM is available as an online tool that can inform local HBP deliberation and support efficient investment in UHC, especially as countries pivot towards non-communicable disease and injury care. Funding Bill & Melinda Gates Foundation, Trond Mohn Foundation, and Norwegian Agency for Development Cooperation.Background The Sustainable Development Goals (SDGs), which aim to halve global traffic deaths by 2020, will not be met by most low-income and middle-income countries (LMICs). In Latin America and the Caribbean (LAC) region, traffic deaths have remained stable at a high-level despite strong progress in other health domains. We evaluated the effects of road safety interventions in LAC and estimated the benefits that vehicle design improvements would have in this region. Methods In our study done in October, 2018, we used a counterfactual analysis to assess the reduction in deaths and disability-adjusted life years (DALYs) lost if eight proven vehicle safety technologies were made more widely available in LAC countries. We estimated (1) country-level incidence of traffic injuries, (2) the effectiveness of technologies through a systematic literature review, (3) the prevalence of car safety technologies, and (4) the lives saved and DALYs averted if all cars had these technologies. We characterised uncertainty in to be prioritised in the SDG agenda for 2030. Funding Inter-American Development Bank.Background Overall increases in the uptake of HIV testing in the past two decades might hide discrepancies across socioeconomic groups. We used data from population-based surveys done in sub-Saharan Africa to quantify socioeconomic inequalities in uptake of HIV testing, and to establish trends in testing uptake in the past two decades. Methods We analysed data from 16 countries in sub-Saharan Africa where at least one Demographic and Health Survey was done before and after 2008. We assessed the country-specific and sex-specific proportions of participants who had undergone HIV testing in the previous 12 months across wealth and education groups, and quantified socioeconomic inequalities with both the relative and slope indices of inequalities. We assessed time trends in inequalities, and calculated mean results across countries with random-effects meta-analyses. https://www.selleckchem.com/products/fadraciclib.html Findings We analysed data for 537 784 participants aged 15-59 years (most aged 15-49 years) from 32 surveys done between 2003 and 2016 (16 before 2008, and 16 after 2008) in Cameroon, Côte d'Ivoire, DR Congo, Ethiopia, Guinea, Kenya, Lesotho, Liberia, Malawi, Mali, Niger, Rwanda, Sierra Leone, Tanzania, Zambia, and Zimbabwe.