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The "Assessing National Capacity for the Prevention and Control of Noncommunicable Diseases: Report of the 2021 Global Survey" by WHO examines the global state of readiness and infrastructure for managing noncommunicable diseases (NCDs) across countries. Based on the 2021 survey, it analyzes nationa
...
l capabilities in public health infrastructure, policies, health systems, and the impact of the COVID-19 pandemic on NCD-related resources. The report highlights gaps and strengths in NCD prevention, treatment, and health policy integration, offering insights for improving NCD care worldwide. It emphasizes the need for multisectoral collaboration and targeted actions to meet global health goals.
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Health system resilience is not an inevitable byproduct of any investment in health but must be intentionally programmed and developed with necessary input, investment and contextualization. This technical product aims to guide national, subnational, and global health actors to operationalize the co
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ncept of health system resilience for advancement of universal health coverage, health security and ultimately better health for all. It supports the translation of relevant conceptual guidance and high-level recommendations into practical actions.
The specific objectives are to:
present a concise overview of the concept of health system resilience;
provide a roadmap outlining practical and foundational steps for building health system resilience to be adapted to different contexts;
share examples of actions and tools, including stakeholder roles, to support country application of the roadmap.
The target audience for this work is the various stakeholders involved in strengthening health systems and public health including management of emergencies (from prevention and preparedness to response and recovery) and other public health challenges in countries. This ranges from the donors, policy-makers and decision-makers at global, national and subnational levels to the implementing institutions and line managers of health system functions and services across the health system building blocks.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions
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(FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr
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ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
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This study identifies barriers and provides recommendations to improve asthma care in children across sub-Saharan Africa, where qualitative data is lacking despite high rates.
The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highlights the significant global impact of CRDs, including
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asthma, chronic obstructive pulmonary disease (COPD), and other related conditions, particularly in low- and middle-income countries (LMICs). The document stresses the need for effective prevention strategies and better surveillance, as well as enhanced healthcare infrastructure and resources in LMICs. It calls for research into CRD risk factors, effective interventions, and integrated care approaches that align with broader NCD prevention programs. The article emphasizes the importance of public health initiatives and cross-sector collaborations to reduce the disease burden and improve patient outcomes.
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The aim of the Technical Brief is to offer guidance to education professionals on how to integrate Mental Health and Psychosocial Support into Education in Emergencies programming. An overview of Mental Health and Psychosocial Support activities that can be implemented in Education in Emergencies co
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ntexts is detailed, in line with the MHPSS Minimum Service Package. Country examples and case studies are featured.
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Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa
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ctors (microbial exposure, exposure to passive smoking and air pollution), seemed to contribute to this trend. The increased prevalence observed in metropolitan areas with respect to rural ones and, overall, in industrialized countries, highlighted the role of air pollution in asthma inception. Asthma accounts for 1.1% of the overall global estimate of “Disability-adjusted life years” (DALYs)/100,000 for all causes. Mortality in children is low and it decreased across Europe over recent years. Children from LMICs particularly suffer a disproportionately higher burden in terms of morbidity and mortality. Global asthma-related costs are high and are usually are classified into direct, indirect and intangible costs. Direct costs account for 50–80% of the total costs. Asthma is one of the main causes of hospitalization which are particularly common in children aged < 5 years with a prevalence that has been increased during the last two decades, mostly in LMICs. Indirect costs are usually higher than in older patients, including both school and work-related losses. Intangible costs are unquantifiable, since they are related to impairment of quality of life, limitation of physical activities and study performance. The implementation of strategies aimed at early detect asthma thus providing access to the proper treatment has been shown to effectively reduce the burden of the disease.
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Risk factors for asthma among schoolchildren who participated in a casecontrol study in urban Uganda
Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We conducted a case-control study, among 555 cases and 1115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertia
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ry education for fathers (adjusted OR (95% CI); 2.32 (1.71–3.16)) and mothers (1.85 (1.38–2.48)); area of residence at birth, with children born in a small town or in the city having an increased asthma risk compared to schoolchildren born in rural areas (2.16 (1.60–2.92)) and (2.79 (1.79–4.35)), respectively; father’s and mother’s history of asthma; children’s own allergic conditions; atopy; and cooking on gas/electricity. In conclusion, asthma was associated with a strong rural-town-city risk gradient, higher parental socio-economic status and urbanicity. This work provides the basis for future studies to identify specific environmental/lifestyle factors responsible for increasing asthma risk among children in urban areas in LMICs.
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Antimicrobial resistance (AMR) has emerged as a leading cause of death in the African region, surpassing fatalities from malaria, HIV, and TB. In response to this critical threat, the region has adopted the AMR Global Action Plan and the African Union Framework for Antimicrobial Resistance Control 2
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020 – 2025, which is tailored to meet the specific needs of African nations through a coordinated approach. While most countries in the region have developed and prioritized National Action Plans (NAPs) to tackle AMR, the overall response remains inadequate given the magnitude of the threat, which endangers human, animal, environmental, aquatic, and plant health.
Africa bears a significant burden of infectious diseases, accounting for approximately 95% of malaria deaths, 70% of people living with HIV, and 25% of TB deaths globally. In 2019, AMR was linked to approximately 55,000 deaths from HIV, 30,000 from malaria, and 255,000 overall. Major drivers of AMR in the region include the overuse and misuse of antimicrobials in human and food systems, migration, suboptimal vaccination rates, and environmental contamination from hospital and pharmaceutical effluents. Additionally, there is a lack of access to quality-assured antimicrobials and diagnostics, compounded by inadequate knowledge about AMR. Unlike high-income countries, where indiscriminate antimicrobial use is the primary factor driving AMR, African countries face additional challenges, including a lack of access to clean and safe water, poor Water, Sanitation, and Hygiene (WASH) programs, inadequate infection prevention measures, and suboptimal vaccinations for preventable diseases. One in three hospitals in the region lacks clean, safe running water, and one in eight people defecate openly due to inadequate sanitation. Investments in WASH, infection prevention, and biosecurity could save approximately 700,000 lives annually.
Addressing AMR in Africa requires a comprehensive, multi-sectoral approach involving the entire society. Sustainable access to antimicrobials, including antibiotics, vaccines, and therapeutics, is crucial, as lack of access leads to more morbidity and mortality than AMR itself. Support for the region should focus on preventing infections, strengthening health and food systems, developing human resources, ensuring sustainable access to diagnostics and therapeutics, and investing in laboratory infrastructure to support surveillance and data generation.
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This UNAIDS 2024 report brings together new data and case studies which demonstrate that the decisions and policy choices taken by world leaders this year will decide the fate of millions of lives and whether the world’s deadliest pandemic is overcome.
The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma and Allergies in Childhood (ISAAC) and The International Union Against Tuberculosis and Lung Disease (T
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he Union) to monitor asthma and improve asthma care, particularly in low- and middle-income countries (LMICs).
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The 2023 update of the Global Strategy for Asthma Management and Prevention incorporates new scientific information about asthma based on a review of recent scientific literature by an international panel of experts on the GINA Science Committee. This comprehensive and practical resource about one o
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f the most common chronic lung diseases worldwide contains extensive citations from the scientific literature and forms the basis for other GINA documents and programs.
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The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge and practice at the date of publication. When assessi
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ng and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local and national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge and practice at the date of publication. When assessi
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ng and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local or national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk for TB disease after infection depends on several factors, the most important being the person’s im
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munological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance
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Chronic respiratory diseases, such as asthma and
chronic obstructive pulmonary disease, kill more than
four million people every year and affect hundreds
of millions more. These diseases erode the health
and well-being of the patients and have a negative
impact on families and societies. Women
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and
children are particularly vulnerable, especially those
in low and middle income countries, where they are
exposed on a daily basis to indoor air pollution from
solid fuels for cooking and heating. In high income
countries, tobacco is the most important risk factor
for chronic respiratory diseases, and in some of
these countries, tobacco use among women and
young people is still increasing.
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Research globally has shown that metered dose inhaler (MDI) technique is poor,
with patient education and regular demonstration critical in maintaining correct use of
inhalers. Patient information containing pictorial aids improves understanding of medicine
usage; however, manufacturer leaflets i
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llustrating MDI use may not be easily understood by
low-literacy asthma patients.
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Childhood Respiratory Diseases & the Environment learning objectives
•To understand how the respiratory tract is affected by the environment
•To describe respiratory diseases linked to the environment
•To list one population-level intervention and one personal-level intervention for d
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ecreasing risk of respiratory diseases
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Asthma is a serious global health problem affecting all age groups. Its prevalence is increasing in many countries, espacially among children. Although some countries have seen a decline in hospitalizations and deaths from asthma, asthma still imposes an unacceptable burden on health care systems, a
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nd on society through loss of productivity in the workplace and, espacially for pediatric asthma, disruption to the family.
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