Chromoblastomycosis (CBM), represents one of the primary implantation mycoses caused by melanized fungi widely found in nature. It is characterized as a Neglected Tropical Disease (NTD) and mainly affects populations living in poverty with significant morbidity, including stigma and discrimination.
This volume contains monographs prepared at the ninety-first meeting of the Joint FAO/WHO Expert Committee on Food Additives (JECFA), which met virtually online from 1 to 12 February 2021.
The detailed monographs in this volume summarize data on specific contaminants in food. Individual monographs ...present the assessment of exposure to cadmium from all food sources, the technical, analytical, dietary exposure and toxicological data on ergot alkaloids, an assessment of five substances that may occur as previous cargoes, and a revision of the specifications for steviol glycosides. This volume and others in the WHO Food Additives series contain information that is useful to those who produce and use food additives and veterinary drugs and those involved with controlling contaminants in food, government and food regulatory officers, industrial testing laboratories, toxicological laboratories and universities.
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The 2021 Report examines country health spending patterns and trends over the past 20 years, before the COVID-19 pandemic, with greater focus on public spending on health. The report also presents spending on primary health care, preliminary health expenditure in 2020 for a small set of countries (i...ncluding their health spending on COVID-19) and an analysis of high-income countries spending patterns, in particular during the global financial crisis. The report also points out the need for more public investment in health to get progress towards UHC back on track and strong health security.
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WHO-OHCHR launch new guidance to improve laws addressing human rights abuses in mental health care
Ahead of World Mental Health Day, the World Health Organization (WHO) and the Office of the High Commissioner on Human Rights (OHCHR) are jointly launching a new guidance, entitled "Mental health, h...uman rights and legislation: guidance and practice", to support countries to reform legislation in order to end human rights abuses and increase access to quality mental health care.
Human rights abuses and coercive practices in mental health care, supported by existing legislation and policies, are still far too common. Involuntary hospitalization and treatment, unsanitary living conditions and physical, psychological, and emotional abuse characterize many mental health services across the world.
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This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector development plans and the Health Sector Reform Strategy ...2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
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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.
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tub...erculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
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The Disability inclusion guide for action supports ministries of health and their partners in both advancing health equity for persons with disabilities by identifying entry points, and planning appropriate actions that strengthen the health system through disability inclusion. It focuses on address...ing the contributing factors which relate to the health system – namely, the attitudinal,
institutional, and physical barriers faced by persons with disabilities across all health system building blocks. Such factors include the exclusion of persons with disabilities in governance and decision-making processes in the health sector; gaps in knowledge, negative attitudes, and discriminatory practices among the health and care workforce; inaccessible physical infrastructure, health
information and communication; and a lack of information or data collection and analysis on disability in monitoring and evaluation in the health system.
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Following the release of the Wheelchair Service Training Package – Basic level (WSTP-B), WHO in partnership with United States Agency for International Development (USAID) has developed the Wheelchair Service Training Package – Intermediate Level (WSTP-I). WSTP-I is the second part of the WHO w...heelchair service training package series and focusses more on addressing the needs of people who have severe difficulties in walking and moving around and also having poor postural control . While developing this training package, special attention was given on the provision of appropriate wheelchairs for children who have poor postural control and are unable to sit upright independently.
Purpose of the training
The need for wheelchair personnel is universal. WSTP-I is designed to support the training of personnel or volunteers to provide an appropriate manual wheelchair and cushion for children and adults who need additional postural support to sit upright. The main purpose of this training package is to:
increase the number of wheelchair users who receive a wheelchair which meets their needs;
increase the number of personnel trained in intermediate level wheelchair service delivery;
improve the competencies of wheelchair service delivery personnel;
increase the quality of wheelchair service delivery for people who need a comparatively higher level of intervention than basic level;
include this training package in regular paramedical/rehabilitation training programmes;
achieve greater integration of wheelchair service delivery within rehabilitation services.
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Comprehensive public health action on population ageing is urgently needed. This will require fundamental shifts, not just in the things we do, but in how we think about ageing itself. The World report on ageing and health outlines a framework for action to foster Healthy Ageing built around the new... concept of functional ability. Making these investments will have valuable social and economic returns, both in terms of health and wellbeing of older people and in enabling their on-going participation in society
Executive summaries : Arabic; Chinese; English; French; German; Japanese; Portuguese; Russian; Spanish
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This document is written for medical doctors, clinical officers, medical assistants, nurses, midwives, health surveillance assistants (HSAs), and medical records clerks who are working in public and private sector health facilities in Malawi. It is designed to be a practical guide for implementation... of integrated HIV services.
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The 23rd meeting of the WHO Expert Committee on Selection and Use of Essential Medicines was coordinated from Geneva, Switzerland, and held virtually from 21 June to 2 July 2021. The Committee considered 88 applications proposing additions, changes and deletions of medicines, medicine classes and fo...rmulations on the Model Lists of Essential Medicines. The Committee evaluated the scientific evidence for comparative effectiveness, safety and cost-effectiveness of the medicines in question. The Committee also considered a review of the therapeutic alternatives for medicines on the Model Lists, and update to the AWaRe classification of antibiotics, and reviews and reports relevant to the selection and use of essential medicines.
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This report is jointly released by the Human Rights Division (HRD)
of the United Nations Mission in South Sudan (UNMISS) and the Office of the United Nations High Commissioner for Human Rights (OHCHR) and focuses on the right to freedom of opinion and expression in South Sudan.
It covers the per...iod from July 2016 to December 2017 and presents
information gathered by HRD on progress and challenges faced by
individuals to freely form, hold and express their opinions and
views on a wide range of issues, including the political and security situation, peace negotiations, and other developments affecting the country.
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This report is primarily intended for the community of policymakers and researchers concerned about the rising risks of domestic, regional, and global infectious disease epidemics, and the collective failure to take the coordinated actions required to reduce such risks. These risks include the expec...ted health, economic, and societal costs that are borne by countries, regions, and even all nations in the case of pandemics (which are worldwide epidemics). These risks also include the consequences of increasing antimicrobial resistance (AMR) and its spread within regions and globally. A necessary first step is to monitor whether a broad range of stakeholders are acting to prevent outbreaks from becoming epidemics, whether their capacities to respond to epidemics are robust, and whether preparedness to respond to pandemics and limit the resulting economic and health damage is improving. Analyzing the adequacy of these efforts is vitally important for the decisions of policymakers to invest in the public health and disaster-risk management capacities. Early and effective control of disease outbreaks prevents substantial health and economic costs whether or not the disease can spread globally and become a pandemic.
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Review of International, Regional and National Policies and Legal Frameworks that Promote Migrants and Mobile Populations' Access to Health and Malaria Services in the Greater Mekong Subregion (Cambodia, Lao People's Democratic Republic, Myanmar, Thailand and Viet Nam)
Migrants and mobile popul...ations face many obstacles in accessing equitable essential health care services due to factors such as living and working conditions, education level, gender, irregular migration status, language and cultural barriers, anti-migrant sentiments, and lack of migrant-inclusive health policies among others. Despite significant progress having been made in the context of malaria control in the Greater Mekong Subregion (GMS), human movements can impact malaria transmission patterns and potentially introduce drug-resistant parasites. This legal framework review therefore serves as a guidance document on approaches to address malaria and malaria elimination for migrant and mobile populations (MMPs) in five countries of the GMS.
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Based on WHO South-East Asia Regional Strategy on Autism Spectrum Disorder
The collaborative framework for implementation of the “WHO South-East Asia Regional Strategy on Autism Spectrum Disorders” articulates to Member States: the nature of autism spectrum disorder and the issues faced by ...PwASD and their caregivers; the foundation on which the Regional Strategy and the collaborative framework is based; desired outcomes against each objective of the ASD Regional Strategy; recommended actions to fulfill each objective; requisite parameters that should govern the recommended actions; and suggested guidelines for monitoring, evaluating and reporting a Member State’s progress towards fulfilling the objectives. It encourages Member States to share best practices and information for promoting cooperation and partnerships for development of effective and sustainable programmes.
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The study collected data on the impact of HIV-related diseases on income, revenues, economic dependency, consumption, education, health, food security, stigma, discrimination, quality of life, and migration. The study also assessed people living with chronic diseases in order to compare the impact o...f living with HIV/AIDS with the impact of living with a chronic disease.
Stigma, discrimination, and socio-economic exclusion continue to affect the rights and socio-economic opportunities of people living with HIV in Myanmar. Households with a family member who has HIV, have lower incomes, fewer assets and lower home-ownership, compared to households that are not affected by HIV. They also have more household debt, and their families pay a higher rate of interest compared to families not affected by HIV.
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The aim of this study is to research deeply on the post-traumatic stress disorder in sexually abused children. Proving the presence of forms of the disorder in children and the their treatment mode will be in the center of the study. The methods used to conduct this study will be a literature review... on the focused issue referring to reviews of articles which focus on the defined peer group. For the purpose we have selected only articles focusing on sexually abused children treated for post-traumatic stress disorder. The results of the study reveal that all forms of abuse could bring consequences on children, even more, posttraumatic stress is the language with which the victims communicate their sorrow in the most typical mode. Sexual abuse as one of the major forms of abuse, is among the most severe which cause irreversible consequences over a category of children. In conclusion we can assume that post-traumatic stress in sexually abused children might appear through the most severe forms of psychiatric and psychological symptoms and for the recovery and rehabilitation of the child in many cases the pharmacological treatment seems as the best choice for the child.
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