This South-East Asia Regional Strategy for Primary Health Care: 2022-2030 aims to accelerate progress in all countries of the Region towards universal health coverage (UHC), health security and the health-related Sustainable Development Goals (SDGs). It is intended to provide Member States with guid...ance on facilitating PHC-orientation through the identification of seven values and 12 strategic actions that collectively embody the philosophy and practice of PHC, enunciated in the 1978 Declaration of Alma-Ata and reaffirmed in the 2018 Declaration of Astana.
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As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and sustained reduction
in institutional maternal mortality... (iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
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This document provides an overview of key considerations for the provision of the HIV continuum of care in the context of displaced people from Ukraine in the EU/EEA. This document has two aims: firstly, to outline what is known of the Ukrainian HIV epidemic, and secondly, to use the HIV continuum o...f care as a framework to set out suggestions based on published evidence and expert opinion on the management of the HIV continuum of care, with special consideration for people living with HIV from Ukraine. The document will also address the needs of those at risk of acquiring HIV. The main findings of this document were presented during an ECDC webinar, ‘Key considerations on the continuum of HIV care for refugees from Ukraine,’ hosted on 19 May 2022.
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PLoS Neglected Tropical diseases August 16, 2021 https://doi.org/10.1371/journal.pntd.0009697
Chagas disease, also known as American trypanosomiasis, is a neglected tropical disease transmitted by triatomine insects, first identified in 1909. Chagas disease affects approximately 6–7 million peop...le globally and is highly prevalent in Latin America where most cases are reported. However, there is increasing evidence that Chagas disease is now an important public health issue outside the “classical” endemic countries due to population migration. Our understanding of Chagas disease, including its pathologies and factors relating to progression, remains to date limited, and is also challenged by lack of diagnosis and highly effective treatment. This systematic review aims to describe studies with Chagas patients receiving antiparasitic treatment. Databases were searched for relevant studies published after 1997, and the results of these searches were screened.
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Chagas disease (CD) is endemic in the Americas, being present in 21 countries, where it affects about 6 million
people.(1) With such relevant numbers of people affected and disability adjusted life years lost, CD is a poverty-related
and poverty-promoting disease.
Although data describe a relevan...t ongoing public health problem for the American continent, significant results
in the interruption of transmission has been achieved by coordinated multi-country programs. In particular, the
Southern Cone Initiative (SCI), officially formalised in November 1991 by the Ministers of Health of Argentina, Brazil, Bolivia, Chile, Paraguay and Uruguay, has shown how a well-designed control program can significantly reduce
CD transmission.(2) Before this initiative, in these countries, there were 11 million infected persons and 50 million at
risk, 62% of the infected individuals of the whole continent.
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Gambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1990s. Thanks to recent innovations such as rapid di...agnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence.
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A 7.7 magnitude earthquake struck at 04:17 local time on 6 February 2023, with its epicentre located in Pazarcık district
in Kahramanmaraş province, Türkiye. Over 1200 aftershocks have since been reported. These are Türkiye’ s most powerful
earthquakes since 1939
Cervical cancer continues to be a significant public health problem and a major cause of premature mortality among women, disproportionately affecting the socioeconomically disadvantaged population in low- and middle-income countries (LMICs). In the absence of implementing the known evidence-based, ...cost-effective interventions, the number of deaths per year is projected to reach approximately 416 000 globally in 2035. It was estimated in 2020 that 32% of incident cervical cancer cases and 34% of cervical cancer deaths in the world occurred in the 11 Member States of the WHO South-East Asia (SEA) Region. In 2020, 190 874 new cases and 116 015 deaths were estimated due to cervical cancer, which is the third commonest cancer in the Region
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The cholera outbreak has affected 14 countries in the WHO African Region. The climate-induced natural disasters such as cyclone and flooding in the southern African region and drought in the Horn of Africa led to increase in cases of cholera in many of the affected countries. With the rainy season c...ommencement in the west African region there is risk of more cholera outbreaks on the horizon. The trend across the region is being closely monitored and this highlights the need for Member States to enhance readiness, heighten surveillance and institute preventive and control measures in communities and around border crossings to prevent and mitigate cross border infection. Since 1 January 2022, a cumulative number of 213 443 cholera cases has been reported to the WHO Regional Office for Africa (AFRO), including 3 951 deaths with a case fatality ratio (CFR) of 1.9% as of 16 July 2023 (Table 1). Malawi accounts for 28% (58 941) of the total cases and 45% (1 766) of all deaths reported, and together with Cameroon, Democratic Republic of the Congo, Mozambique, and Nigeria contribute to 85% (181 300) of the overall caseload and 88% (3 464) of cumulative deaths. In Epidemiologic week 28, six countries Burundi, Cameroon, Ethiopia, Kenya, Malawi and Mozambique reported a total of 667 new cases.
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The World Health Organization (WHO) is releasing the second edition of its Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance. The document aims to equip governments to respond to the health and well-being challenges, opportunities and needs of adolescents.
The guidance pro...vides the latest available data on adolescent health and well-being. It also outlines an updated list of core indicators that data should be collected on. Globally, road injury was the top cause of death for adolescent males in 2019. Among female adolescents, the leading causes of death were diarrhoeal diseases among the younger group (10-14 years) and tuberculosis (TB) in the older group (15-19 years).
Over the last 20 years, mortality rates have declined among adolescents globally, with the largest decline in older (15–19 years) adolescent girls. For non-fatal diseases, the burden has not improved over the past two decades, with the main causes of ill health in this category being: mental health conditions (depressive and anxiety disorders, childhood behavioural disorders), iron deficiency anaemia, skin diseases and migraine.
Adolescent well-being depends on a range of factors, including healthy food, education, life skills and employability, connectedness, feeling valued by society, safe and supportive environments, resilience, and the freedom to make choices. To take an appropriately holistic approach, the guidance outlines how to take crosscutting action to support adolescent health and well-being, with mutually reinforcing interventions across sectors, such as health, education, social protection, and telecommunications. Targeted efforts are also required to engage adolescents, as they trust health systems less than adults do and are especially vulnerable to modern-day trends, like online bullying and gaming.
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Cardiovascular diseases (CVDs) have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study has tracked trends in death and disability since 1990 a...nd has provided an updated perspective on the status of cardiovascular health globally, regionally, and nationally.
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It is estimated that 422 million people in the world live with diabetes. WHO forecasts that this number will reach 622 million by 2040. The majority of people with diabetes live in developing countries. The number of people with diabetes is increasing, notably in Africa, from 3 adults among 100 peop...le in 1980 to 7 adults among 100 people in 2014.
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sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support ...optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times.
The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care:
• continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment
• to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms
• to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA)
• to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma
• to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and
• to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma.
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Mpox is an emerging zoonotic disease caused by the mpox virus, a member of the Orthopoxvirus genus closely related to the variola virus that causes smallpox. Mpox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research. The first human case was recorde...d in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox and since then the infection has been reported in a number of African countries. Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels, and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA. Two separate clades of the mpox virus are currently circulating in Africa: Clade I, which includes subclades Ia and Ib, and Clade II, comprising subclades IIa and IIb. Clade Ia and Clade Ib have been associated with ongoing human-to-human transmission and are presently responsible for outbreaks in the Democratic Republic of the Congo (DRC), while Clade Ib is also contributing to outbreaks in Burundi and other countries.
In 2022‒2023 mpox caused a global outbreak in over 110 countries, most of which had no previous history of the disease, primarily driven by human-to-human transmission of clade II through sexual contact. In just over a year, over 90,000 cases and 150 deaths were reported to the WHO. For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent. On 13 Aug 2024, Africa CDC declared the ongoing mpox outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017.7 This declaration empowered the Africa CDC to lead and coordinate responses to the mpox outbreak across affected African countries. On August 14, 2024, the WHO declared the resurgence of mpox a Public Health Emergency of International Concern (PHEIC) emphasizing the need for coordinated international response.
As of August 2024, Mpox has expanded beyond its traditional endemic regions, with new cases reported in countries including Sweden, Thailand, the Philippines, and Pakistan. Sweden has confirmed its first case of Clade 1 variant, which has been rapidly spreading in Africa, particularly in DRC. The emergence of this new variant raises concerns about its potential for higher lethality and transmission rates outside Africa.
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Monkeypox Factsheet in English
Hesperian’s fact sheet is one of the first accessible yet comprehensive health resources on Monkeypox. We describe common symptoms of monkeypox, how to prevent its spread, and how it can be treated at home. We also note how the world seems to have learned nothing fr...om COVID about the need for vaccine equity! Translations of this factsheet will soon be available in several languages.
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La promoción del lavado de manos es fundamental para minimizar la transmisión de SARS-COV-2 y para salvar vidas. Una de las maneras más frecuentes de trasmisión de SARS-COV-2 es a través de manos contaminadas al tocarse la boca, la nariz y los ojos. También se puede transferir el virus de una ...superficie a otra a través de las manos contaminadas. Acceso gratuito y uso mandatorio de estaciones de lavado de manos ayudaría a minimizar la transmisión del virus de COVID y a salvar vidas.
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The State of the world’s nursing 2020 report provides the latest, most up-to-date evidence on and policy options for the global nursing workforce. It also presents a compelling case for considerable – yet feasible – investment in nursing education, jobs, and leadership.
The primary chapters... of the report outline the role and contributions of nurses with respect to the WHO “triple billion” targets; the health labour market and workforce policy levers to address the challenges to nurses working to their full potential; the findings from analysis of National Health Workforce Account (NHWA) data from 191 Member States and progress in relation to the projected shortfall of nurses by 2030; and forward-looking policy options for an agenda to strengthen the nursing workforce to deliver the Sustainable Development Goals, improve health for all, and strengthen the primary health care workforce on our journey towards universal health coverage.
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The report – Global Status Report on Preventing Violence Against Children 2020 – is the first of its kind, charting progress in 155 countries against the “INSPIRE” framework, a set of seven strategies for preventing and responding to violence against children. The report signals a clear need... in all countries to scale up efforts to implement them. While nearly all countries (88%) have key laws in place to protect children against violence, less than half of countries (47%) said these were being strongly enforced.
The report includes the first ever global homicide estimates specifically for children under 18 years of age – previous estimates were based on data that included 18 to 19-year olds. It finds that, in 2017, around 40,000 children were victims of homicide.
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The humanitarian situation in the Central African Republic (CAR) has further worsened over the past six months. Election-related violence that broke out in mid-December 2020 has had a devastating effect on civilians. Thousands of people have been forced to flee, human rights violations have surged, ...hundreds of schools and dozens of hospitals have been forcibly closed and food prices have skyrocketed. This deterioration occurred in an already alarming context, with more than half of the population (2.8 million people) in need of humanitarian assistance and protection and 1.9 million people in acute need. In the past five years, there have never been as many people in humanitarian distress in CAR as today.
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At least 2.2 million people were exposed to the earthquake, about 2,100 people have died, and more than 12,000 were injured as at 20 August. The death toll is expected to rise as the search for victims trapped under rubble continues. The Government has declared a month-long state of emergency for th...e most affected departments (LCI 19/08/2021; USAID 18/08/2021 a).
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