Injection practices worldwide and especially in low- and middle-income countries (LMICs) include multiple, avoidable unsafe practices that ultimately lead to the large-scale transmission of bloodborne viruses among patients, health care providers and the community at large.
These WHO interim recommendations for use of the BBV152 COVAXIN vaccine were developed on the basis of advice issued by the Strategic Advisory Group of Experts on Immunization (SAGE) and the evidence summary included in the background document and annexes referenced below.
This document has been ...updated: version 15 March 2022.
The vaccine is formulated from an inactivated SARS-CoV-2 antigen and is presented in single dose vials and multidose vials of 5, 10 and 20 doses.
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For humanitarian organisations to respond effectively to complex crises, they require access to up-to-date evidence-based guidance. The COVID-19 crisis has highlighted the importance of updating global guidance to context-specific and evolving needs in humanitarian settings. Our study aimed to under...stand the use of evidence-based guidance in humanitarian responses during COVID-19. Primary data collected during the rapidly evolving pandemic sheds new light on evidence-use processes in humanitarian response.
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Climate change and health vulnerability and adaptation assessment
In 2013 the World Health Organization (WHO) published the report Protecting health from climate change:
vulnerability and adaptation assessment. The aim was to provide basic and flexible guidance on conducting national or subnati...onal assessments of current and future vulnerability (the susceptibility of a population or region to harm) to the health risks of climate change, and of policies and programmes that could increase resilience, taking into account the multiple determinants of climate-sensitive health outcomes.
That guidance has been a very useful tool, applied to more than 50 countries and settings, and has helped countries to prepare their health contributions to United Nations Framework Convention on Climate Change national adaptation plans.
Since the launch of the guidance, WHO, technical partners such as Health Canada, and countries have learned much in terms of its applicability in different countries, at national and local levels.
At the same time, knowledge on climate change and health has increased.
WHO, the Pan American Health Organization and Health Canada have produced this updated version, which aims to better support countries in their assessments by proposing a simpler tool that incorporates all lessons learned.
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PHARMA’S RESPONSE TO THE COVID-19 VACCINES CRISIS. Update Feb., 14, 2022. In September 2021, Amnesty International published A Double Dose of Inequality, which assessed the extent to which the pharmaceutical industry was restricting access to Covid-19 vaccines. This report updates that assessment ...of five leading vaccine manufacturers, AstraZeneca plc, BioNTech SE, Johnson & Johnson, Moderna Inc., and Pfizer Inc. It also includes for the first time an assessment of the two largest Chinese vaccine producers, China National Pharmaceutical Group Co., Ltd. (Sinopharm) and Sinovac Biotech Ltd. (Sinovac).
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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 of an on-going partnership between WHO, UNEP and UNICEF in the area of chi...ldren’s environmental health, and seeks to update the 2002 joint publication “Children in the New Millennium: Environmental Impact on Health.”
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The world agreed to achieve 17 Sustainable Development Goals by 2030. Nine planetary boundaries set an upper limit to Earth system impacts of human activity in the long run. Conventional efforts to achieve the 14 socio-economic goals will raise pressure on planetary boundaries, moving the world away... from the three environmental SDGs. We have created a simple model, Earth3, to measure how much environmental damage follows from achievement of the 14 socio-economic goals, and we propose an index to track effects on people’s wellbeing. Extraordinary efforts will be needed to achieve all SDGs within planetary boundaries.
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The climate crisis has many consequences – among them widespread health impacts that will lead to immense societal, ecological, and economic harm.
Over the past two decades multiple large-scale reviews on climate change and health have made clear the need for a multi-sectoral approach to target t...he drivers and impacts of climate change, biodiversity loss, and ecosystem degradation. Despite this abundance of scientific evidence underscoring urgency of action, policy implementation responses lag behind. Even at COP26, itself delayed due to an ongoing pandemic, health continues to be considered by many countries a problem independent from climate and environment.
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PNAS 119 (8) e2113947119 | https://doi.org/10.1073/pnas.2113947119
Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, m...easure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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A global food crisis fuelled by conflict, climate shocks and the COVID-19 pandemic is growing because of the ripple effects of the war in Ukraine driving rising prices of food, fuel and fertilizer. Millions of people across the world are at risk of being driven into starvation unless action is taken... now to respond together and at scale. Due to the unprecedented overlap of crises, WFP’s annual operational requirements are at an all-time high of US$22.2 billion, with confirmed contributions so far at US$4.8 billion (22 percent). WFP is calling for coordinated action to address this crisis.
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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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This brochure draws on data from more than 90 nationally representative surveys making it the most up-to-date compilation of statistics on FGM/C. Available data show that the practice of FGM/C is highly concentrated in a swath of countries from the Atlantic coast to the Horn of Africa, in areas of t...he Middle East such as Iraq and Yemen and in some countries in Asia like Indonesia. However, FGM/C is a human rights issue that affects girls and women worldwide. Evidence suggests that FGM/C exists in some places in South America such as Colombia and elsewhere in the world including in India, Malaysia, Oman, Saudi Arabia, and the United Arab Emirates.
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Over the ages, human societies have altered local ecosystems and modified regional climates. Today the human influence has attained a global scale. This reflects the recent rapid increase in population size, energy consumption, intensity of land use, international trade and travel, and other human a...ctivities. These global changes have heightened awareness that the long-term good health of populations depends on the continued stability of biosphere's ecological, physical and socioeconomic systems.
The world's climate system is an integral part of the complex of life-supporting processes. Like other large systems, the global climate system is coming under pressure from human activities.
This book seeks to describe the context and process of global climate change, its actual or likely impacts on health, and how human societies and their governments should respond with particular focus on the health sector.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim...ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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Sleeping sickness is controlled by case detection and treatment but this often only reaches less than 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because of expense. We conducted a full scale field trial of a refined vector control tec...hnology. From preliminary trials we determined the number of insecticidal tiny targets required to control tsetse populations by more than 90%. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda (overall target density 5.7/km2). In 12 months tsetse populations declined by more than 90%. A mathematical model suggested that a 72% reduction in tsetse population is required to stop transmission in those settings. The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this new method of vector control to case detection and treatment is strong. We outline how such a component could be organised.
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UNHCR invested significantly in risk mitigation, prevention and response to sexual exploitation and abuse (SEA) in the Europe region in 2022-2023, in particular in connection with the Ukraine emergency, where the risks were considered high due to the unprecedented scale and speed of displacement, mo...stly women and children, combined with high turnover of humanitarian staff and the range of new and untraditional actors involved in the response. PSEA also remains a priority for UNHCR’s work for other refugees, internally displaced and stateless persons across the region.
This compilation highlights the 10 most promising practices that were initiated by UNHCR and its partners in the Europe region in 2022-2023. These practices are shared with the aim to inspire further work on PSEA in the region and elsewhere and encourage continuous learning and exchange.
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Asbestos, the most frequent cause of occupational cancer, continues to be consumed ona massive scale, with millions of people exposed on a daily basis. This review explains why we havefailed in curtailing the silent epidemic of asbestos-related disease and why the numbers of asbestosvictims are like...ly to remain high. Emerging and developed countries have to be reminded that asbestosexposure has yet to become a problem of the past. The worldwide spread of asbestos, followed by thesurge of asbestos-related cancers, resembles the lung cancer epidemic caused by smoking andstimulated by manufacturers.
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A regional guide for governments in Asia and the Pacific to review, update and develop policies to address antimicrobial resistance and antimicrobial use in animal production
In the past ten years, the number of forcibly displaced people has nearly doubled. In 2019, the number of people forced to flee (inside and beyond the borders) grew to 79.5 million – the highest ever recorded. Refugee situations continue to increase in scope, scale and complexity, whereas durable ...solutions provided to refugees are at levels that fall well below needs.
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The winter season is approaching fast, while older people (OP) and people with disabilities (PwD) have already been living in the harsh environment of a full-scale war for eight months, with their basic needs and human rights at risk of being neglected and violated for eight years of ongoing war.
T...he recent brutal attacks on the critical infrastructure facilities such as power plants and power substations in eight regions of Ukraine, including Kyiv, show the alarming prediction that this winter is going to be challenging for the affected areas, especially for the vulnerable people residing there
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