The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to outline the current knowledge available on the situation of health and well-being of older persons ...in the Americas at the beginning of the United Nations Decade of Healthy Aging (2021-2030), this document presents data and existing evidence different forms of discrimination and mistreatment older people face due to their sexual orientation and gender identities that ultimately increase health disparities. Previous studies on LGBTI older people offer valuable information on the lived experiences of these communities and demonstrate that they face unique challenges with aging, emphasizing the difficulties related to access to care. Very few studies on older people and aging include a focus on sexual orientation or gender identity; however, it is possible to point out that HIV/AIDS is one of the most significant health disparities confronting LGBTI older persons, followed by physical and mental health problems, substance use, social isolation, poverty, and the lack of access to quality healthcare, including long-term care facilities or other institutions. Closing the gap in access and quality of health and care services is an imperative to increase longevity, health status and quality of life of LGBTI older people.
more
The chapter Closing the Gap: The Health Disparities of Older LGBTI People in the Americas, is part of the publication series titled ‘Decade of Healthy Aging: situation and challenges’. In order to outline the current knowledge available on the situation of health and well-being of older persons ...in the Americas at the beginning of the United Nations Decade of Healthy Aging (2021-2030), this document presents data and existing evidence different forms of discrimination and mistreatment older people face due to their sexual orientation and gender identities that ultimately increase health disparities. Previous studies on LGBTI older people offer valuable information on the lived experiences of these communities and demonstrate that they face unique challenges with aging, emphasizing the difficulties related to access to care. Very few studies on older people and aging include a focus on sexual orientation or gender identity; however, it is possible to point out that HIV/AIDS is one of the most significant health disparities confronting LGBTI older persons, followed by physical and mental health problems, substance use, social isolation, poverty, and the lack of access to quality healthcare, including long-term care facilities or other institutions. Closing the gap in access and quality of health and care services is an imperative to increase longevity, health status and quality of life of LGBTI older people.
more
This document is an output of a WHO cross-programme initiative aiming to improve the prevention, diagnosis and management of anaemia and thereby accelerate reduction in its prevalence. It comes at an important time, midway through the era of the Sustainable Development Goals, when progress in reduci...ng anaemia has stagnated. This framework is based on the core principles of primary health care: meeting people’s health needs through comprehensive promotive, protective, curative, and rehabilitative care along the life course; systematically addressing the broader determinants of health; and empowering individuals, families, and communities to optimize their health
more
To assess national-level responses to NCDs, WHO has implemented NCD country capacity surveys periodically since 2001. This report is the latest in that series. Since the first survey round, the NCD Country Capacity Survey (NCD CCS) has been conducted a further seven times, most recently in 2021. In ...the survey, completed by the NCD focal point within each country’s ministry of health or similar agency, countries are asked to report on the following topics relating to NCDs: (i) public health infrastructure, partnerships and multisectoral collaboration; (ii) policies, strategies and action plans; (iii) health information systems and surveillance; (iv) health system capacity for detection, treatment and care; and, added for 2021, (v) the impact of the COVID-19 pandemic on NCD-related resources and activities. The questionnaire is web-based and requires supporting documentation wherever possible. In the 2021 round, data were collected from May onwards, with the last survey responses arriving in September. Validation was carried out by WHO regional offices and WHO headquarters. Country responses to previous rounds of the survey were incorporated into the analysis to assess progress since 2010. Although all 194 Member States responded to the survey, data comparisons were restricted to the 160 countries that had responded to all rounds of the survey since 2010.
more
The Sustainable Development Goals (SDGs) call for major societal transformations that will require significant fiscal outlays as well as private investments. The fiscal outlays cover public investments, the public provision of social services, and social protection for vulnerable populations. The ke...y message of this paper, building on recent reports by the IMF and SDSN (IMF, 2019b; SDSN, 2018) is that the governments of Low-Income Developing Countries (LIDCs) will require a substantial increase in fiscal (budget) revenues, far beyond what they can achieve by their own fiscal reforms. For this reason, SDG financing will require substantial international cooperation to enable the LIDCs to finance their SDG fiscal outlays. One important source of increased revenues should be the globally coordinated taxation of ultra-high-net worth assets. Today’s ultra-rich should help to pay for the survival and basic needs of the world’s poorest people.
more
The importance of robust mortality surveillance systems cannot be overstated in an era marked by increasing global health challenges where health threats loom large and population dynamics continue to evolve. Accurate and timely mortality data is essential for identifying trends and detecting emergi...ng health threats, evaluating the impact of interventions, and guiding evidence-based policy decisions.
This framework outlines a holistic approach to strengthening routine mortality surveillance systems, considering the unique contextual factors and challenges faced by African countries. It emphasizes the importance of establishing efficient data collection mechanisms, enhancing data quality and completeness, and promoting data sharing and collaboration among stakeholders.
Moreover, the framework recognizes the pivotal role of technology in the integration of data from fragmented mortality data sources. It highlights the potential of innovative data capture methods, advanced analytics, and real-time reporting systems to enhance mortality data’s accuracy, efficiency, and timeliness.
The continental framework for mortality surveillance aligns with Africa CDC’s mission and strategic goal by serving as a fundamental component in strengthening public health systems, enhancing disease surveillance capacities and capabilities, informing evidence-based policies and interventions, and promoting collaboration and coordination among African countries to address health challenges and improve health outcomes on the continent.
The successful implementation of this framework requires collective commitment and concerted efforts from governments, health institutions, and the international community. We hope this document will serve as a catalyst for transformative change, enabling countries to build resilient mortality surveillance systems that protect public health, save lives, and contribute to evidence-based decision-making.
more
The UK government hosted the Global Vaccine Summit on June 4, 2020 under the patronage of the Rt. Hon. Boris Johnson, Prime Minister of the United Kingdom of Great Britain and Northern Ireland. The meeting was held by videoconference in light of the ongoing COVID-19 pandemic. 2. The Summit brought... together more than 300 people, including 42 Heads of State and Government. 62 countries were represented, notably 14 Gavi implementing countries, all of the G7 nations and 19 governments of the G20. Eminent participants also included H.E. Antonio Guterres, Secretary-General of the United Nations; H.E. Moussa Faki Mahamat, Chairperson of the African Union Commission; H.E. Dr Tedros Adhanom Ghebreyesus, WHO Director-General; H.E. Henrietta Fore, UNICEF Executive Director; Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation; Ministers from implementing and donor countries; CEOs of vaccine manufacturing companies and private sector partners; leaders of UN and other international agencies; senior civil society representatives; and Gavi champions. A full list of the participants can be found in Annex.
more
Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequency. In addition to resulting in high mortality and morbidity, the outbreaks generate fear and mistrust about the response activities within the communities affected.
Infection prevention and control (IP...C) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
more
The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline... is available both online and PDF.
**This version of the living guideline (version 5.0) **includes the following seven revised statements for the prevention, identification and management of SARS-CoV-2 infections among health and care workers:
a good practice statement on national and subnational testing strategies;
a good practice statement on passive syndromic surveillance of health and care workers;
a good practice statement on prioritizing health and care workers for SARS-CoV-2 testing;
a good practice statement on protocols for reporting and managing health and care worker exposures;
a good practice statement to limit in-person work of health and care workers with active SARS-CoV-2 infections;
a statement on high-risk exposures and quarantine; and,
a conditional recommendation on the duration of isolation for health and care workers.
Understanding the updated section
Prevention of infections in the health care setting includes a multi-pronged and multi-factorial approach that includes IPC and occupational health and safety measures and adherence to Public Health and Social Measures in the community by the health workforce. The underlying infection prevention and control strategy of this section is the notion that early identification of symptomatic cases, testing and quarantining/isolating health and care workers decreases the risk of nosocomial infection to patients and to other health and care workers.
more
Financing Global Health 2013: Transition in an Age of Austerity, IHME’s fifth annual report on global health expenditure, depicts financing trends that underline the resilience of development assistance for health. This year’s updated estimates show that despite lackluster economic growth and fi...scal cutbacks in many developed countries, total assistance remained steady, reaching an all-time high of $31.3 billion in 2013. While annual increases have leveled off since 2010, continued international funding is a sign of the international development community’s enduring support for global health.
The report also shows shifts in sources of financing. As funding from many bilateral donors and development banks has declined, growth in funding from the GAVI Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, non-governmental organizations, and the UK government is counteracting these cuts. Development assistance for different health issues is tracked up to 2011, revealing that the greatest increase in funding was for maternal, newborn, and child health.
more
WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
more
The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline... is available both online and PDF.
This version of the living guideline (version 6.0) includes fifteen statements on IPC measures in health-care settings (screening and patient placement, ventilation, physical barriers, environmental cleaning, waste management, amongst others) as well as one statement on mask fit in the community context.
more
Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
more
Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
more
Strategic communication is at the heart of public health and more important than ever in the digital age. Using communication strategically requires expertise, skills and resources to plan, implement and evaluate interventions that encourage governments to implement policies that improve people’s ...lives and well-being, that empower health workers to deliver the best care possible, and that encourage people to take actions that protect and improve their health and that of their family and community. This Regional Action Framework on Communication for Health (C4H) aims to support Member States in implementing the C4H approach. It outlines steps to be taken by WHO and Member States to use C4H to achieve shared public health goals in the Western Pacific.
more
Ethiopia has been repeatedly affected by conflict, flooding, drought, and disease outbreaks in the past years. As of January 2024, the country is actively responding to the longest recorded cholera outbreak which started in August 2022, recurrent measles outbreaks which started in August 2021, and t...he highest number of malaria cases reported since 2017. The El Niño phenomenon is expected to cause further havoc up to July 2024, by causing drought in some parts of the country, and flooding in others. Food insecurity due to lost harvest and livestock is aggravating already high malnutrition rates, negatively impacting morbidity and mortality.
The Health Cluster is closely collaborating with the Ministry of Health (MOH) to prepare for, prevent, and respond to public health emergencies by mobilizing resources to enable health partners to provide life-saving health services to vulnerable populations.
In an environment with ever-increasing needs and decreased funding, the below priorities for 2024 and 2025 have been identified: 1 Strengthen advocacy for longer-term, development funding to address root causes of recurrent disease outbreaks, including through the Humanitarian-Development-Peace Nexus 2 Advocate for increased access to quality health services, with a strong focus on:
sexual and reproductive health services (including for survivors of sexual and gender-based violence)
inclusion of people with disabilities, older people, and people living with HIV
remote populations through inclusion of Mobile Health Teams (MHT) as part of the health system 3 Standardize health services provided by Health Cluster partners through the implementation of Essential Health Care packages, aligned with existing MOH guidance, aimed at ensuring quality service delivery for affected populations, especially at community level 4 Strengthen quality of, and access to data for needs analysis and informed decision-making 5 Strengthen subnational coordination, with increased focus on zones and local health partners
more
At the global, national, and regional levels, there are several guidelines and guides regarding the preparedness, prevention, surveillance, and control of diseases caused by respiratory viruses; most initiatives focus on specific virus events or cases. During the coronavirus disease 2019 (COVID-19) ...pandemic, it has been found that even when there are strategies designed and planned for pandemics, it is necessary to strengthen and improve them. Planning for imminent threats, including those posed by respiratory viruses, contributes to strengthening the core capacities of the International Health Regulations (IHR [2005])
more
Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was... the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
more
The document provides detailed clinical guidelines for the therapy of Type 1 Diabetes as developed by the German Diabetes Association (DDG). It focuses on individualized insulin therapy, structured patient training, and monitoring of blood glucose levels. The guidelines emphasize preventing complica...tions like ketoacidosis and hypoglycemia while improving patients' quality of life through education and tailored medical care. Recommendations include the use of both basal and bolus insulin, continuous glucose monitoring, and integrating psychosocial support into treatment plans. The document serves as a comprehensive resource for healthcare professionals managing Type 1 Diabetes.
more
Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A...Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
more