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Pathogen genomic surveillance has become a priority for public health systems in recent years. Genomic sequencing is increasingly being used to characterize pathogens and monitor important public health priorities (e.g. poliovirus, influenza virus, Mycobacterium tuberculosis and Vibrio cholerae, ant
...
imicrobial resistance (AMR)). The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the role that sequencing plays in the surveillance of infectious diseases. Sequencing facilitates earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution and tailored development and evaluation of interventions to inform local to global public health decision-making and action. However, there remains a need to coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data (GSD) with clinical and epidemiological data to strengthen its utility.
more
To assess the impact of the COVID-19 pandemic on health and HIV expenditure, UNAIDS carried out a modelling study on fiscal space for health and HIV. From a sample of 28 countries, three countries—the Democratic Republic of the Congo, Jamaica, and Lesotho—were selected to capture health and HIV
...
expenditure impacts across countries with especially marked differences in burdens of disease (including HIV prevalence), HIV donor dependency, level of economic development, and geographic location. While the three-country sample is too small to permit findings to be generalized to other countries, these analyses are useful for informing UNAIDS’ work to identify some policy positions to minimize the COVID-19 pandemic’s impact on the HIV response.
more
Multiple pandemics, numerous outbreaks, thousands of lives lost and billions of dollars of national income wiped out—all since the turn of this century, in barely 17 years—and yet the world’s investments in pandemic preparedness and response remain woefully inadequate. We know by now that the
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world will see another pandemic in the not-too-distant future; that random mutations occur often enough in microbes that help them survive and adapt; that new pathogens will inevitably find a way to break through our defenses; and that there is the increased potential for intentional or accidental release of a synthesized agent. Every expert commentary and every analysis in recent years tells us that the costs of inaction are immense. And yet, as
the havoc caused by the last outbreak turns into a fading memory, we become complacent and relegate the case for investing in preparedness on a back burner, only to bring it to the forefront when the next outbreak occurs. The result is that the world remains scarily vulnerable.
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Financing Global Health 2015 is the seventh edition of IHME’s annual series on global health financing. This report captures trends in development assistance for health (DAH) and government health expenditure as source (GHE-S) in low- and middle-income countries. Annually updated GHE-S and DAH est
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imates are produced to aid decision-makers and other global health stakeholders in identifying funding gaps and invesment opportunities vital to improving population health. This year, IHME made a number of improvements to the data collection and methods implemented to generate Financing Global Health estimates.
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Marco Schäferhoff and colleagues critique funding estimates for the maternal and child health Millennium Development Goals, and make recommendations for improving the tracking of financing flows and estimating the costs of scaling up interventions for mothers and children.
The environment in which young people live, learn and play significantly affects their decisions about whether to consume alcohol. Environmental factors are the main risk factors driving alcohol consumption and related harm among young people. Environments that normalize alcohol consumption – term
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ed alcogenic environments – include contexts with unregulated advertising and marketing of alcoholic beverages, higher alcohol outlet density, products designed to facilitate affordability and low prices of alcoholic beverages. A recent body of research evidence has emerged related to the measurement, functional significance and consequences of living in alcogenic environments. This includes findings on the complex and bidirectional interactions among alcohol acceptability, availability and affordability and how they create and perpetuate alcogenic environments. Comprehensive and enforced alcohol control policies are effective at delaying the age of onset and lowering alcohol prevalence and frequency among young people. Evidence consistently confirms the effectiveness of designing and implementing alcohol control policies that regulate upstream the drivers of alcogenic environment, including alcohol availability, acceptability and affordability. These policies need to be multipronged and address the complex interactions between these drivers and the local alcohol culture
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While there has been real progress in addressing the burden of disease in the WHO African region, the COVID-19 pandemic has highlighted the link between health, economics and security, as the region saw decades of progress threatened, including positive trends in decreasing inequality. In the Africa
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n Region the momentum towards achieving the 2030 SDG disease burden reduction targets (SDG targets 3.3, 3.4 and 3B) has stalled.
The COVID-19 pandemic was also a major threat to gains made, such as the eradication of polio in the region, declared in 2020; reduced numbers of new HIV infections in 2021 compared to 2010; and passing the 2020 milestone of the End TB Strategy, with a 22% reduction in new cases compared with 2015. However, the pandemic also disrupted essential health services in 92% of countries globally, 22.7 million children missed basic immunization, there was an increase in malaria and TB, and global deaths from TB rose for the first time since 2015.
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Los avances en el tratamiento del cáncer pediátrico han permitido ampliar las iniciativas más allá de la curación y abarcar aspectos como la detección precoz, la continuidad del tratamiento y la reducción de su toxicidad. Todo ello ha abierto paso a una visión más integral del cuidado de lo
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s pacientes, lo que supone mejores oportunidades de curación y una vida más plena, objetivos de la Iniciativa Mundial contra el Cáncer Infantil. Dentro de ese cuidado integral, la atención psicosocial incluye las dimensiones social, psicológica, espiritual y funcional del proceso de enfermedad de los pacientes. Esta serie recoge una serie de orientaciones y normas basadas en la evidencia que garantizan la calidad de dicha atención. Las normas son el resultado de la discusión y la revisión de distintos profesionales de América Latina y el Caribe. El módulo 1 se centra en la evaluación psicosocial como estrategia de apoyo a los objetivos de la Iniciativa Mundial contra el Cáncer Infantil y como herramienta para que los profesionales de la salud recaben la información necesaria para ofrecer a estos pacientes un abordaje integral enfocado en el bienestar, la adaptación al proceso de enfermedad y la adherencia al tratamiento.
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Access to safe blood and blood products is recognized as one of the key requirements for delivery of modern health care in the journey towards health for all. The foundation of safe and sustainable blood supplies depends on the collection of blood from voluntary non-remunerated and low-risk donors.
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Data from the WHO Global Database for Blood Safety (GDBS) brings out several inadequacies related to the supply and safety of blood and blood products. These inadequacies include a number of variations in safe blood practices across the world, including the quantity of blood donated (voluntary and replacement types), quality and adequate testing of the donated blood (immunohaematology [IH] and transfusion-transmitted infections [TTIs]), rational use of blood and blood components such as appropriate patient blood management protocols. These variations are very high in countries of the South-East Asian Region and most of them are either low- or middle-income countries (LMICs).
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This action plan is intended for senior-level decision-makers in ministries of health, malaria
programme managers, entomologists, and epidemiologists working on malaria and other vectorborne diseases programmes. It is also intended for decision-makers and technical and advocacy
staff at other orga
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nizations and stakeholders involved in public health, malaria control and
elimination, and urban and rural development.
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This brief update on tuberculosis (TB) in the African region covers the state of TB in the WHO African region, strategic priorities and targets and the impact of COVID-19 on essential services. This is followed by key figures for the region, the role of WHO in country support and, recognizing the im
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portance of diagnosis and drug susceptibility testing, a focus onstrengthening laboratory networks and the regional laboratory and diagnostic objectives. A brief update of the state of the science and how this is funded across the African region is provided, before closing with challenges and opportunities,strategic directions and a brief discussion of funding concerns. Discussions around the drivers of the disease, and issues of the poverty, inequality and stigma that continue to plague those living with TB are fully recognized, but are outside the scope of this report.
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The key actions, activities, and approaches in this document are organized within each of the 5Cs (see Table 1 in the PDF) and those of the Strategic preparedness and response plan (SPRP) pillars as follows:
National action plan key activities, prioritized for the current context and the current
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understanding of the threat of SARS-CoV-2
A. Transition from emergency response to longer term COVID-19 disease management.
B. Integrate activities into routine systems.
C. Strengthen global health security.
Special considerations for fragile, conflict-affected and vulnerable (including humanitarian) settings
WHO global and regional support to Member States to implement their national action plans
Key guidance documents for reference
This is a living document that will be updated to incorporate new technical guidance in response to the evolving epidemiological situation. National plans should be implemented in accordance with the principles of inclusiveness, respect for human rights, and equity.
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This guide presents a basis for understanding how diarrhoeal diseases are currently influenced by climate and weather, and may be further exacerbated by climate change. It is a technical guide on how to conduct a Vulnerability & Adaptation assessment for diarrhoeal diseases and climate change, and p
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rovides guidance on how to:
identify populations and regions vulnerable to diarrhoeal diseases and the reasons for their vulnerability;
establish relevant baselines that can be analysed and monitored;
conduct analyses to project how diarrhoeal diseases may be impacted in the future due to climate change; and
identify appropriate responses to mitigate and monitor these risks over time.
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: Development assistance for health (DAH) is one of the most important means for Japan to promote
diplomacy with developing countries and contribute to the international community. This study, for the first time,
estimated the gross disbursement of Japan’s DAH from 2012 to 2016 and clarified its
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flows, including source, aid
type, channel, target region, and target health focus area
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Donor financing to low- and middle-income countries for reproductive, maternal, newborn, and child health increased substantially from 2008 to 2013. However, increased spending by donors might not improve outcomes, if funds are delivered in ways that undermine countries’ public financial managemen
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t systems and incur high transaction costs for project implementation
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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
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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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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig
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h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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Infection prevention and control (IPC) in a CTC/ CTU IPC are all practical measures taken in the healthcare facility to prevent harm caused by infections to patients, health workers and communities.
The main goal of IPC in the cholera response is to
• To reduce transmission of health care-as
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sociated infections of cholera and any other infectious disease
• To enhance the safety of staff, patients and visitors
• To enhance the ability of the organization/health care facility to respond to an outbreak
• To reduce the risk of the hospital (health care facility) itself amplifying the outbreak
Water, Sanitation and Hygiene (WASH)
WASH are all measures taken to guarantee environmental hygiene, safe water of all used within the health facility. It encompasses water, sanitation, waste management, cleaning within the health facility which in this case is CTU/C. A complete WASH package in the CTU/CTC reduces the risk of spread of Vibrio cholerae inside and outside the CTC/CTU.
The probability of spreading or acquiring cholera through a CTC/CTU can be highly reduced when proper IPC and WASH measures are respected, followed and monitored. These measures are, in principle, valid in CTC/CTUs and ORPs, although they need to be adapted to the specific characteristics of the facility concerned.
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The Water and Sanitation for Health Facility Improvement Tool (WASH FIT) presents a framework and acts as a guide to support multisectoral action to improve water, sanitation and hygiene (WASH) in health care. Central to the WASH FIT methodology is training and incremental improvements.
Implementat
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ion of WASH FIT requires six preparatory steps at the national level, one of which is conducting national sensitization and training of trainers, followed by facility-level training. At the facility level, step 1 (of five) involves establishing and training a WASH FIT team.
The WASH FIT methodology is outlined in WASH FIT: A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities. Second edition. (the WASH FIT guide), which includes a set of templates designed to help users with each phase of the improvement cycle.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety and quality of care. Such services are also essential for creating an environment that supports the dig
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nity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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