BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379
Rapid Recommendation and visual graph. This is the fifth version (update 4) of the living guideline (BMJ 2020;370:m3379). When citing this article, please consider adding the update number and da
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te of access for clarity. The publication of the RECOVERY and REMAP-CAP randomised controlled trials triggered this guideline update, resulting in a strong recommendation for interleukin-6 (IL-6) receptor blockers (tocilizumab or sarilumab) in patients with severe or critical covid-19.
Prior recommendations: (a) A recommendation not to use ivermectin in patients with covid-19, regardless of disease severity, except in the context of a clinical trial; (b) a strong recommendation against the use of hydroxychloroquine in patients with covid-19, regardless of disease severity; (c) a strong recommendation against the use of lopinavir-ritonavir in patients with covid-19, regardless of disease severity; (d) a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19; (e) a conditional recommendation against systemic corticosteroids in patients with non-severe covid-19; and (f) a conditional recommendation against remdesivir in hospitalised patients with covid-19.
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Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of
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both interventions in low-resource settings. This study aimed to test both interventions in low-income and middle-income countries.
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The Fourth National Climate Assessment (NCA4) fulfills that mandate in two volumes. This report, Volume II, draws on the foundational science described in Volume I, the Climate Science Special Report (CSSR).2 Volume II focuses on the human welfare, societal, and environmental elements
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of climate change and variability for 10 regions and 18 national topics, with particular attention paid to observed and projected risks, impacts, consideration of risk reduction, and implications under different mitigation pathways. Where possible, NCA4 Volume II provides examples of actions underway in communities across the United States to reduce the risks associated with climate change, increase resilience, and improve livelihoods.
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national programmes for occupational health and safety for health workers: lessons learned from countries: summary report of the WHO online workshop, 15 July 2020
March 2022. This report on good practices to combat AMR focuses on activities across human, animal, and environmental health in European countries. The report provides a description of practices, how they were implemented, achievements, and why the
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practice was unique.
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There is little doubt that 2019 was a defining year on many fronts for the environment. The repercussions of the climate emergency were experienced across the globe, with floods, devastating wildfires, and unprecedented melting
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of polar ice sheets and glaciers. While the new decade began with the Australian bushfires still raging after the hottest and driest year on record, the world was soon (and still is) in the grip of the COVID-19 pandemic.
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This booklet presents key messages for action, summarized from a set of
chapters on different environmental health issues.
This booklet presents key messages for action, summarized from a set of chapters on different environmental health issues, available at www.who.int/ ceh/publications/healthyenvironmentsforhealthychildren. The work is a result
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of an on-going partnership between WHO, UNEP and UNICEF in the area of children’s environmental health, and seeks to update the 2002 joint publication “Children in the New Millennium: Environmental Impact on Health.”
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This guideline covers indoor air quality in residential buildings. It aims to raise awareness of the importance of good air quality in people's homes and how to achieve this.
nt. J. Environ. Res. Public Health 2014, 11(12), 13097-13116; https://doi.org/10.3390/ijerph111213097
Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Healt
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h care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.
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Health Policy and Planning, Volume 35, Issue 1, February 2020, Pages 47–57, https://doi.org/10.1093/heapol/czz122
Colombia has an underreporting of 30% of the total cases, according to World Heal
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th Organization (WHO) estimations. In 2016, successful tuberculosis (TB) treatment rate was 70%, and the mortality rate ranged between 3.5% and 10%. In 2015, Colombia adopted and adapted the End TB strategy and set a target of 50% reduction in incidence and mortality by 2035 compared with 2015.
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This document aims to encourage countries to develop and implement policies to maintain and strengthen IPC programmes and measures in health care facilities in the context of the current ongoing transmission
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of the SARS-CoV-2, with recognition that epidemiological trends may vary and the risk of transmission of other pathogens.
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Int. J. Environ. Res. Public Health 2021, 18(24), 13339; https://doi.org/10.3390/ijerph182413339
The climate crisis threatens to exacerbate numerous climate-sensitive health risks, including heatwave mortality, malnutrition from reduced crop yields, water- and vector-borne infectious diseases, and
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respiratory illness from smog, ozone, allergenic pollen, and wildfires. Recent reports from the Intergovernmental Panel on Climate Change stress the urgent need for action to mitigate climate change, underscoring the need for more scientific assessment of the benefits of climate action for health and wellbeing.
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Cryptococcal disease, particularly cryptococcal meningitis is a significant cause of morbidity and mortality among people living with HIV with advanced HIV disease. It is estimated that it is responsible for nearly 19%
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of AIDS-related mortality, second only to tuberculosis. Rapid screening, diagnosis and linking to appropriate treatment are critical actions national programs must take to reduce the burden of disease.
WHO in 2022 introduced updated guidelines for diagnosing, preventing, and managing cryptococcal disease among adults, adolescents and children living with HIV. This policy brief provides a summary of the key recommendations, clinical considerations, and also stresses the importance of ensuring access to life-saving antifungals. There is an urgent need for countries to scale-up management for not just cryptococcal meningitis, but address cryptococcal disease in the context of a package of care for advanced HIV disease as recommended by WHO.
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This document is a guide defining requirements for quality and safety for malaria rapid diagnostic testing services to safeguard the quality of the results, the safety of the operators and patients
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and that of the environment for use by national malaria control programmes, regulators, implementers and rapid diagnostic providers.
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Human Papilloma Virus (HPV) is the most common sexually transmitted infection, and two types of HPV (16 and 18) cause nearly 50% of high-grade cervical pre-cancers. HIV and cervical cancer are inext
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ricably linked. Women living with HIV are six times more likely to develop cervical cancer, which is one of the AIDS-defining illnesses and the most common cancer among women living with HIV globally. Cervical cancer is a preventable, curable disease and can be eliminated as a public health problem with primary and secondary prevention, treatment, and care of cervical cancer, in combination with addressing social, health and other inequalities and integrated approaches.
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This document is an addendum to the Revised Supplementary Appeal issued in April 2022, reflecting UNHCR’s updated financial requirements for the Ukraine situation for March to December 2022. UNHCR is appealing for an additional $170 million for activities within Ukraine, to scale up urgentlyneeded
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winterization and other ongoing programmes, under the four-month extension of the Ukraine Flash Appeal issued in August 2022.
Updated situation
There are 17.7 million people in Ukraine in urgent need of protection and assistance, including 6.2 million who are internally displaced. Housing conditions for millions of people have become increasingly perilous since the start of the international armed conflict.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region
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of the Americas. In its final report on the Plan of Action to Accelerate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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This Strategic Operating Framework (SOF) has been developed to guide WASH Sector partners in responding to humanitarian needs in Sudan in conjunction with the existing and forthcoming humanitarian response plans (2022 and 2023). This SOF is drafted in consultation with the Strategic Advisory Group (
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SAG) at the national level and will be revised as the humanitarian situation evolves in line with changes made to the WASH Cluster response plan and other guidance received by the SAG and the Technical Working Groups. However, by adhering to the cluster (Sector) approach, the partners agree to:
Assist the authorities in responding to the WASH needs of the population affected.
Promote a common understanding of the WASH sector needs and interventions in the response context among the WASH partners.
Ensure a well-coordinated response and consequently increase the efficiency, effectiveness, and impact of individual agency responses; and
Align towards common humanitarian principles and operational objectives.
Partners to conform to the broad operational framework outlined in this document. Agencies that breach these guidelines will be expected to provide clear justification to the WASH Sector and other WASH Sector partners through the SAG
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This thematic brief accompanies the Working for Health 2022–2030 Action Plan, serving as a rationale to the related actions of the Working for Health progression model (see Annex). The brief aims to inform Member States, non-state actors and othe
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r users of the Action Plan to guide action on investments on strengthening protection and performance of the health and care workforce, including the relevant policy landscape, key challenges and future directions.
In doing so, it provides an expanded exploration of the themes beyond what is provided in the Action Plan itself and reflects the topical issues and considerations that shaped its design, including those issues identified in the World Health Assembly Resolution WHA74.14 to protect, safeguard and invest in the health and care workforce (1). The importance of these themes was again emphasized at the Seventy-fifth World Health Assembly, when Resolution WHA75.17: Human resources for health was co-sponsored by over 100 Member States, calling for the adoption and implementation of the Working for Health 2022–2030 Action Plan and utilization of the related Global Health and Care Worker Compact
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