In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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Social distancing is an action taken to minimise contact with other individuals; social distancing measures comprise one category of non-pharmaceutical countermeasures (NPCs)1 aimed at reducing disease transmission and thereby also reducing pressure on health services.
This document builds upon exi...sting ECDC documents, including guidelines for the use of non-pharmaceutical measures to delay and mitigate the impact of 2019-nCoV, a rapid risk assessment: outbreak of novel coronavirus disease – 5th update, a technical report on the use of evidence in decision-making during public health emergencies, and a guidance document on community engagement for public health events caused by communicable disease threats in the EU/EEA.
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Guiding principles for reuse are:
Respirators which have been visibly contaminated (e.g. during procedure at intubated patients, such as suction cleaning of airways, taking probes, extubation attempts, etc.) or are damaged or not fitting, should be discarded and cannot be taken for re-use or de...contamination procedures.
Respirators may be protected by a medical face mask in order to prevent soiling.
Use of new ‘expired respirators’ (manufacturers expiry date) is possible if they were properly stored until use.
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Working Document Nov. 2020
The COVAX Supply and Logistics workstream lead by UNICEF, Gavi and WHO have released a working copy of the COVID-19 Vaccination, Country Readiness & Delivery: Supply and Logistics Guidance. Countries might find this Guide useful when developing and strengthening their sup...ply chain strategies to receive, store, distribute and manage the COVID-19 vaccines and their ancillary products, in line with their national deployment and vaccination plan (NDVP). The document also provides links to the different tools and resources to aid countries in performing assessment, planning and capacity-building activities.
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Licensed pharmaceutical products (marketing authorization) should be manufactured only by licensed manufacturers (holders of a manufacturing authorization) whose activities are regularly inspected by competent national authorities. This guide to GMP shall be used as a standard to justify GMP status,... which constitutes one of the elements of the WHO Certification Scheme on the quality of pharmaceutical products moving in international commerce, through the assessment of applications for manufacturing authorizations and as a basis for the inspection of manufacturing facilities. It may also be used as training material for government medicines inspectors, as well as for production, QC and QA personnel in the industry
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25 August 2021. The earthquake on August 14, 2021 was almost as strong as the severe quake in 2010, which killed about 300,000 people. The current number of victims is more than 2,200 people, and more than 12,000 people have been injured. More than 52,000 houses were destroyed and more than 77,000 ...damaged. Thousands of families were affected! The magnitude 7.2 earthquake struck southwest Haiti at 8:30 a.m. local time at a depth of about 10 km. The epicentre was measured about 12 km northeast of Saint-Louis-du-Sud, about 125 km west of the capital Port-auPrince. The situation on the ground remains chaotic and the extent of the disaster cannot yet be predicted. In addition, heavy rainfall and the unstable security situation are complicating relief efforts. What is needed most now is food and drinking water, tents and primary health care. MEDBOX has already created the Natural Hazard Toolbox after the severe earthquake in 2010 and has collected many essential materials on health care, shelter & reconstruction after an earthquake in English, French and Kreyol there. In this issue brief, we provide a quick
overview of the most important information.
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History has shown that governments tend to deprioritize environmental commitments during times of financial and public crises as they work to mitigate immediate needs—and the age of COVID-19 has been no different. Even though human interaction with wildlife is believed to be the cause of the pande...mic, the focus on COVID’s fallout has deprioritized the importance of reversing the damage humans have done to the planet.
COVID has had a multifaceted and detrimental effect on environmental conservation. Not only has funding been diverted to deal with the pandemic, conservation-oriented organizations are operating with minimal staff or have closed entirely. People whose daily work it is to advance environmental science and protect the land and water have become ill or have been forced to stay home because of travel restrictions. Plastic use is at an all-time high.
The good news is that there is an unprecedented opportunity for philanthropy to recharge the effort to protect the planet. This Giving Smarter Guide examines the state of environmental philanthropy, and provides an overview of potential strategic starting points for philanthropy and impact capital to play a role in saving the planet. In addition to offering recommendations specific to the COVID-19 response, the Center for Strategic Philanthropy also asks the questions that philanthropists should consider at the start of their journey into the field of conservation philanthropy.
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Trachoma is the leading infectious cause of blindness (2). It is characterized by repeated
conjunctival infection with particular strains of Chlamydia trachomatis. This scars the conjunctivae and,
in some cases, leads to trichiasis with or without entropion. The abrasive action of eyelashes can
d...amage the cornea. In 2018, trachoma affected the poorest residents of the poorest communities of 43
countries
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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.
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Diabetes mellitus, also called diabetes, is a chronic metabolic condition in which the hormone insulin is not produced by the
pancreas in sufficient quantities or is not utilized effectively by the body to control blood glucose levels. As a result, blood
glucose levels are abnormally high (hypergl...ycaemia). Chronic uncontrolled hyperglycemia leads to long-term target organ damage, such as: retinopathy, nephropathy and neuropathy (microvascular complications); stroke, coronary heart disease
and peripheral arterial disease (macrovascular complications).
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The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults over 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm di...agnosis. Cardiovascular risk and target organ damage should be assessed, considering age, lifestyle, and other conditions. Initial treatment focuses on lifestyle changes such as diet, exercise, and smoking cessation, with medication advised for stage 1 hypertension at high cardiovascular risk or stage 2 hypertension. Regular monitoring and treatment adjustments are recommended to maintain target blood pressure levels, with specific guidance for people over 80 and those with additional conditions like diabetes or kidney disease. The guideline aims to reduce risks of heart attack, stroke, and other complications, supporting evidence-based treatment decisions in clinical practice.
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For thousands of years, humans have been using wildlife for commercial and subsistence purposes. Wildlife trade takes place at local, national and international levels, with different forms of wildlife, such as live animals, partly processed products and finished products. Wildlife is a vital source... of safe and nutritious food, clothing, medicine, and other products, in addition to having religious and cultural value. Wildlife trade also contributes to livelihoods, income generation and overall economic development.
However, wildlife trade can have detrimental effects on species conservation, depleting natural resources, impoverishing biodiversity and degrading ecosystems (Morton et al., 2021). Wildlife trade, whether legal or illegal, regulated or unregulated, can pose threats to animal health and welfare. It also presents opportunities for zoonotic pathogens to spill over between wildlife and domestic animals, and for diseases to emerge with serious consequences for public or animal health and profound economic impacts (IPBES, 2020; Swift et al., 2007; Smith et al., 2009; Gortazar et al., 2014; Stephen, 2021; Stephen et al., 2022; FAO, 2020). The risk of pathogen spillover and disease emergence is amplified with increased interaction between humans, wildlife and domestic animals. The risk of pathogen spillover has also been exacerbated by climate change, intensified agriculture and livestock production, deforestation, and other land-use changes. Wildlife trade is also a risk to ecosystem biodiversity via the introduction of invasive species (Wikramanayake et al., 2021). Therefore, increased effort must be put into understanding the potential consequences of the wildlife trade, mapping and analysing the adjacent risks, and implementing strategies to manage those risks. Reducing wildlife-trade risks not only helps to limit disease but also minimises the negative effects of invasive species. Between 1960 and 2021, invasive alien species caused estimated cumulative damage of around 116 billion euros across 39 countries in the European Union alone, despite strict import regulations (Haubrock et al., 2021). The effect of invasive species is extremely apparent.
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CycleBeads is a visual tool that helps women use a fertility-awareness-based method known as the Standard Days Method, as an effective natural family planning method. This advisory note has been prepared to explain the purpose of CycleBeads and the procedure that should be followed to procure them i...n accordance with a specification and quality-assurance assessment
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The Participation Handbook for humanitarian field workers contains detailed practical advice on the participation of affected people in humanitarian action. It has three sections:
Developing a participatory approach (main issues, key factors, building mutual respect, communication methods and... advice on reviewing your approach);
Implementing your participatory approach at every stage of the project cycle (initial assessment, project design, implementation, monitoring and final evaluation);
A list of tools and additional resources (books, internet sites, etc.)
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Clinical guideline, Methods, Evidence and Recommendations
In this guideline the following is covered: information needs of people with chronic hep
titis B and their carers; where children, young people and adults with chronic hepatitis B a-
should be assessed; assessment of liver disease, includi...ng the use of non-invasive tests and genotype testing; criteria for offering antiviral treatment; the efficacy, safety and cost effectiveness of currently available treatments; selection of first-line therapy; management of treatment failure or drug resistance; prophylactic treatment during im-
munosuppressive therapy; and monitoring for treatment response
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The document at hand presents key findings from a project undertaken globally between July 2014 and May 2015 to assess progress made by UNHCR country and regional operations to effectively protect lesbian, gay, bisexual, and transgender, and intersex (LGBTI) asylum-seekers and refugees. Globally, 10...6 offices, or roughly 90% of eligible country and regional operations, participated in the assessment. The key findings are presented along the following axes: legal, cultural and social context; outreach activities; displacement conditions; asylum and durable solutions; training on issues related to sexual orientation and gender identity (SOGI); operational guidelines and advocacy efforts.
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This publication is based on the list of clinical interventions selected from clinical guidelines on prevention, screening, diagnosis, treatment, palliative care, monitoring and end of life care. This publication addresses medical devices for six types of cancer: breast, cervical, colorectal, leukem...ia, lung and prostate. The first section defines the global increase in cancer cases, the global goals to manage NCDs and the WHO activities related to these goals. The second section presents the methodology used for the selection of medical devices that support clinical interventions required to screen, diagnose, treat and monitor cancer stages, as well as the provision of palliative care, based on evidence-based information. The third section lists the priority medical devices required to manage cancer in seven different units of health care services: 1. Vaccination, clinical assessment and endoscopy, 2. Medical imaging and nuclear medicine, 3. Surgery, 4. Laboratory and pathology, 5. Radiotherapy, 6. Systemic therapy and 7. Palliative and end of life care
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Global Biodiversity Outlook (GBO) is the flagship publication of the Convention on Biological Diversity (CBD). It is a periodic report that summarizes the latest data on the status and trends of biodiversity and draws conclusions relevant to the further implementation of the Convention.
GBO-5 pro...vides global summary of progress towards the Aichi Biodiversity Targets and is based on a range of indicators, research studies and assessments (in particular the IPBES Global Assessment on Biodiversity and Ecosystem Services), as well as the national reports provided by countries on their implementation of the CBD. The national reports provide rich information about the steps taken in countries worldwide in support of biodiversity conservation, sustainable use, and the fair and equitable sharing of benefits. This body of Information provides a wealth of information on the successes and challenges in implementing the Strategic Plan for Biodiversity 2011-2020 and in reaching the Aichi Biodiversity Targets.
This Outlook draws on the lessons learned during the first two decades of this century to clarify the transitions needed if we are to realize the vision agreed by world governments for 2050, ‘Living in Harmony with Nature’.
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The threat climate change poses to health, equity, and development has been rigorously documented. However, in an era marked by economic crisis, regional conflicts, natural disasters and growing disparities between rich and poor, the joint global actions required to address climate change have been ...vigorously debated – and critical decisions postponed.
This document, part of WHO’s Health in the Green Economy series, describes how many climate change measures can be “win-wins” for people and the planet.
These policies yield large, immediate public health benefits while reducing the upward trajectory of greenhouse gas emissions. Many of these policies can improve the health and equity of people in poor countries and assist developing countries in adapting to climate change that is already occurring, as evidenced by more extreme storms, flooding, drought and heatwaves.
WHO’s Department of Public Health and Environment launched the Health in the Green Economy initiative in 2010 to review potential health and equity “co-benefits” of proposed climate change measures – as well as relevant risks.
This review examines mitigation strategies discussed in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change which constitutes the most broad-based global review of mitigation options by scientific experts.
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Trachoma causes more vision loss and blindness than any other infection in the world. This disease is caused by Chlamydia trachomatis bacteria. Other variants or strains of these bacteria can cause a sexually transmitted infection (chlamydia) and disease in lymph nodes.
This is photomicrograph ...of a conjunctival smear that revealed the presence of what are known as, intracytoplasmic inclusions Trachoma is easily spread through direct personal contact such as from fingers, through shared towels and clothes, and through flies that have been in contact with the eyes or nose of an infected person. When left untreated, repeated Chlamydia trachomatis infections in the eye can cause severe scarring on the inside of the eyelid. This can cause the eyelashes to scratch the cornea (trichiasis). In addition to causing pain, trichiasis permanently damages the cornea and can lead to irreversible blindness.
Chlamydia trachomatis infections spread in areas that lack access to safely managed drinking water and sanitation systems. Trachoma affects the most resource-limited communities in the world. Globally, almost 1.9 million people have vision loss because of trachoma, and it causes 1.4% of all blindness worldwide.1 In 2021, 136 million people lived in trachoma-endemic areas and were at risk of trachoma blindness.
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