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Publication Years
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Toolboxes
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1
Policy brief. HIV testing services (HTS) and anti-retroviral therapy (ART) have been scaled up substantially. It is estimated that, globally, nearly 80% of people with HIV now know their status. With the offer of immediate ART initiation and improved treat
...
ment options, access to and uptake of treatment have increased, too. Now, most people with HIV who know their status are obtaining treatment and care.
In response to these changes in the global HIV epidemic, WHO is encouraging countries to use three consecutive reactive tests for an HIV-positive diagnosis as their treatment-adjusted prevalence and national HTS positivity fall below 5% .
more
Diagnostic access initiative to achieve the 90-90-90 treatment target
UNAIDS; World Health Organization (WHO); PEPFAR; et al.
UNAIDS; World Health Organization (WHO); PEPFAR; et al.
(2020)
C2
Accessed: 03.03.2020
WHO published guidance for clinicians and health care decision-makers on the use of corticosteroids in patients with COVID-19.
We recommend systemic corticosteroids for the treatment of patients with severe and critical COVID-19. We suggest not
...
to use corticosteroids in the treatment of patients with non-severe COVID-19 as the treatment brought no benefits, and could even prove harmful. Treatment should be under supervision of a clinician.
Corticosteroids are listed in the WHO model list of essential medicines, readily available globally at a low cost. WHO encourages countries to maintain sufficient stocks of corticosteroids to treat COVID-19 and the other disease for which they are effective, while not maintaining excessive stocks which could deny other countries access.
more
Treatment Improvement Protocol (TIP) Series No. 59
This Quick Guide is based entirely on information contained in TIP 59, published in 2014. No additional research has been conducted to update this
...
topic since publication of TIP 59. | This Quick Guide provides succinct, easily accessible information to behavioral health administrators about developing culturally competent organizations. The guide is based entirely on Improving Cultural Competence, Number 59 in the Treatment Improvement Protocol (TIP) series. Users of the Quick Guide are invited to consult the primary source, TIP 59, for more information and a complete list of resources for improving cultural competence. To order a copy of TIP 59 or to access it online, see the inside back cover of this guide.
more
Time has seen management for Cystic Fibrosis (CF) advance drastically, most recently in the development of the disease-modifying triple combination therapy ivacaftor/tezacaftor/elexacaftor. There is currently limited evidence regarding both the global epidemiology of CF and
...
access to this transformative therapy - and therefore where needs are not being met. Therefore, this study aims to define gaps in access to CF treatment. The results show that a significant CF patient burden exists in countries where disease-modifying drugs are unavailable, and final figures are likely underestimates. This analysis shows the potential to improve rates of diagnosis and treatment for CF, so a higher percentage of patients receive the most effective triple combination treatment.
more
The incidence and mortality of cardiovascular diseases (CVDs) in low and middle income countries (LMICs) have been increasing, while access to CVDs medicines is suboptimal. We assessed selection of
...
essential medicines for the prevention and treatment of CVDs on national essential medicines lists (NEMLs) of LMICs and potential determinants for selection.
more
Mycetoma: epidemiology, treatment challenges, and progress
Taha, H.; Fahal, A.; Van de Sande, W.
Dovepress open access to scientific and medical research
(2015)
CC
Mycetoma is a specific chronic, granulomatous, inflammatory disease. It usually involves the subcutaneous tissue, most probably after traumatic inoculation of the causative organism. It has a prolonged, progressive, and indolent course, and, if untreated, it ultimately leads
...
to destruction of the deeper tissues and bone, resulting in deformity and disability that may necessitate amputation of the affected parts with all the social and economic implications of this. The disease is characterized by tumefaction, draining sinuses, and the presence of grains.
more
The risk of increasing rates of acute malnutrition during the COVID-19 pandemic demonstrates the urgent need to adapt, and expand access to, acute
...
malnutrition diagnosis and treatment services in humanitarian and fragile contexts.
more
The brief highlights some findings as part of a project on Innovation for Cancer Care in Africa (ICCA)1. The study provides insights on the experiences of 62 Tanzanian cancer patients, the journey from their first symptoms to the point of diagnosis
...
and treatment. The project brings together researchers from Tanzania, Kenya, India and the United Kingdom to address the opportunities and challenges of linking industry and health systems to widen access to cancer care in Tanzania and Kenya.
more
Policy Brief, Updated in March 2017
Key messages
• The criminalisation of male-to-male sex heightens HIV and other sexually transmissible infection (STI) risks and vulnerabilities, and hinders ... access to HIV and STI services including HCT.
• Men who have sex with men (MSM) and transgender persons (TG) are not a homogeneous group. As such, a variety of HCT service models are needed to reach the various segments of these populations.
• Stigma and discrimination remain ongoing issues at a number of service points. Targeted training of service providers is therefore needed so that MSM and TG are not discouraged from seeking HCT and high-quality prevention, treatment and care services.
• Specific guidelines on HIV prevention, treatment and care services for MSM or TG help improve the delivery of services. more
Key messages
• The criminalisation of male-to-male sex heightens HIV and other sexually transmissible infection (STI) risks and vulnerabilities, and hinders ... access to HIV and STI services including HCT.
• Men who have sex with men (MSM) and transgender persons (TG) are not a homogeneous group. As such, a variety of HCT service models are needed to reach the various segments of these populations.
• Stigma and discrimination remain ongoing issues at a number of service points. Targeted training of service providers is therefore needed so that MSM and TG are not discouraged from seeking HCT and high-quality prevention, treatment and care services.
• Specific guidelines on HIV prevention, treatment and care services for MSM or TG help improve the delivery of services. more
HIV, viral hepatitis and STI epidemics, particularly among people who inject drugs and other key populations, continue to be fuelled by laws and policies criminalizing sex work; drug use or possession; diverse forms of gender expression and sexualit
...
y; stigma and discrimination; gender discrimination; violence; lack of community empowerment and other violations of human rights. These sociostructural factors limit access to health services, constrain how these services are
delivered and diminish their effectiveness.
more
Background
Access to medicines is important for long‐term care of cardiovascular diseases and hypertension. This study provides a cross‐country assessment of availability, prices, and affordabi
...
lity of cardiovascular disease and hypertension medicines to identify areas for improvement in access to medication treatment.
Methods and Results
We used the World Health Organization online repository of national essential medicines lists (EMLs) for 53 countries to transcribe the information on the inclusion of 12 cardiovascular disease/hypertension medications within each country's essential medicines list. Data on availability, price, and affordability were obtained from 84 surveys in 59 countries that used the World Health Organization's Health Action International survey methodology. We summarized and compared the indicators across lowest‐price generic and originator brand medicines in the public and private sectors and by country income groups. The average availability of the select medications was 54% in low‐ and lower‐middle‐income countries and 60% in high‐ and upper‐middle‐income countries, and was higher for generic (61%) than brand medicines (41%). The average patient median price ratio was 80.3 for brand and 16.7 for generic medicines and was higher for patients in low‐ and lower‐middle‐income countries compared with high‐ and upper‐middle‐income countries across all medicine categories. The costs of 1 month's antihypertensive medications were, on average, 6.0 days’ wage for brand medicine and 1.8 days’ wage for generics. Affordability was lower in low‐ and lower‐middle‐income countries than high‐ and upper‐middle‐income countries for both brand and generic medications.
Conclusions
The availability and accessibility of pharmaceuticals is an ongoing challenge for health systems. Low availability and high costs are major barriers to the use of and adherence to essential cardiovascular disease and antihypertensive medications worldwide, particularly in low‐ and lower‐middle‐income countries.
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Over 90% of the morbidity and mortality related to chronic obstructive pulmonary disease (COPD) and asthma occurs in low-income and middle-income countries (LMICs) due to well documented factors inc
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luding decreased access to screening, trained health professionals, and therapies for disease management. Inhaler therapy (eg, aerosolised medications by inhalation, nebulisation, or propellant) is the mainstay of treatment for COPD and asthma. Adherence to maintenance medications for COPD and asthma results in improved lung function and quality of life, as well as decreased hospitalisation and mortality. WHO have included short-acting beta-agonists, long-acting muscarinic antagonists, and inhaled corticosteroids on the essential medications list, with a target goal of achieving 80% availability of these medications in public and private facilities. However, despite these efforts, accessibility, and affordability of medications for COPD and asthma remains scarce.
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Operational considerations for case management of COVID-19 in health facility and community
recommended
This document is intended to guide the care of COVID-19 patients as the response capacity of health systems is challenged; to ensure that COVID-19 patients can
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access life-saving treatment, without compromising public health objectives and safety of health workers.
It promotes two key messages:
1. Key public health interventions regardless of transmission scenario; and
2. Key action steps to be taken by transmission scenario to enable timely surge of clinical operations.
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Keeping communities at the centre of efforts to eliminate lymphatic filariasis: learning from the past to reach a future free of lymphatic filariasis
Krentel, A.; Gyapong, M.; McFarland, D.A.; Ogundahunsi, O.; Titaley, C.R.; Addiss, D.G.
Oxford Academic - International Health
(2021)
CC
Since the launch of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) in 2000, more than 910 million people have received preventive chemotherapy for lymphatic filariasis (LF) and many thousands have received care for chronic manifestat
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ions of the disease. To achieve this, millions of community drug distributors (CDDs), community members and health personnel have worked together each year to ensure that at-risk communities receive preventive chemotherapy through mass drug administration (MDA). The successes of 20 y of partnership with communities is celebrated, including the application of community-directed treatment, the use of CDDs and integration with other platforms to improve community access to healthcare. Important challenges facing the GPELF moving forward towards 2030 relate to global demographic, financing and programmatic changes. New innovations in research and practice present opportunities to encourage further community partnership to achieve the elimination of LF as a public health problem. We stress the critical need for community ownership in the current Covid-19 pandemic, to counter concerns in relaunching MDA programmes for LF.
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The Global Breast Cancer Initiative aims to address disparities in access to care to reduce mort
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ality rates globally. Patient navigation is an evidence-based personalized intervention designed to guide patients through often complex cancer care systems to receive timely access, particularly in low-income and minority populations. It is useful in settings with limited availability, fragmented healthcare systems and socioeconomic barriers that hinder early detection and treatment. It is proven to significantly reduce delays, improve patient adherence to care and enhance survival rates. The model involves helping individuals and their families to tackle barriers such as cultural stigma, misinformation, and psychosocial, among others, that can delay or prevent access to timely care. It can also reduce financial strain, streamline care coordination and improve the overall quality of life by connecting patients with affordable treatment options and support systems to address their needs in the course of treatment.
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Demographic and epidemiological transitions are changing the age structure of the population and the most common diseases. Non-communicable respiratory diseases are an increasing problem at both ends of the age range in low-income and middle-income countries. In children, who represent a large propo
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rtion of the total population, the increasing problem of asthma is a strain on health services. Improved survival of the older population is increasing the proportion of morbidity and mortality attributable to chronic lung diseases. Health services in low-resource countries are poorly adapted to treating chronic diseases. Designed to respond episodically to acute disease, almost all historical investment has focused on infectious diseases. Crucial to the successful management of chronic diseases is an infrastructure designed to support pro-active management, providing not only an accurate diagnosis, but also a secure supply of cost effective drugs at an affordable price. The absence of such an infrastructure in many countries and the market failure that makes drugs generally more expensive in low-resource regions means that many people with chronic non-communicable lung diseases are not given effective treatment. This has damaging economic consequences. The common causes of poor lung health in lowincome countries are not the same as those in richer countries, and there is a need to study why they are so common and how best to manage them.
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BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed.
OBJE
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CTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
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The document focuses on household water treatment methods to ensure access to safe drinking wate
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r, particularly in areas with limited access to clean water sources. It highlights the importance of safe water, noting that contaminated water is a major cause of waterborne diseases such as diarrhea and cholera. Treating water at the household level is emphasized as an effective way to reduce health risks.
The document outlines several treatment methods, including boiling, which kills most pathogens; chlorination, which disinfects water by adding chlorine; filtration, which removes dirt and certain microbes using simple or advanced filters; and solar disinfection (SODIS), which involves exposing water in clear plastic bottles to sunlight for several hours to kill microbes. Additionally, it stresses the importance of safe water storage, such as using clean and covered containers to prevent recontamination, and practicing good hygiene, including regular handwashing and maintaining cleanliness around water sources.
By promoting these methods, the document aims to raise awareness and provide practical solutions for improving water quality at the household level, thereby reducing the spread of diseases and enhancing public health.
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