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Briefing Note 8.
Ecosystem-based adaptation (EbA) is a strategy for adapting to the adverse impacts of climate change by harnessing nature and the services it can provide. This strategy is crucial for cities and peri-urban areas, threatened by a multitude of climate hazards and home to more than ha
...
lf the human population as of 2018. Despite some outmigration from the largest cities during the COVID-19 pandemic, urbanization will continue, and by 2035, 62.5 percent of the world’s population is expected to reside in urban areas. However, given the need to retrofit, replace and upgrade deteriorating urban infrastructure, and to meet the challenges of climate change, including the urban heat island effect, droughts and more intense flooding, many experts and policymakers see in these demands an opportunity to reinvent cities as greener, less prone to pandemics, and more liveable.
more
Lymphatic filariasis (LF), a neglected tropical disease, is targeted for global elimination as a public health problem. This article reviews the history of LF control and elimination activities in the countries of the World Health Organization's (WHO) Eastern Mediterranean Region (EMR) over the last
...
2 decades. In 2000, the estimated at-risk population in EMR countries was 12.6 million people, accounting for approximately 1% of the global disease burden. Of the 22 EMR countries, 3 countries (Egypt, Sudan and Yemen) were LF endemic and the disease was suspected in 4 other countries (Djibouti, Oman, Somalia and Saudi Arabia). After almost 2 decades of implementing sustained control and prevention measures, Egypt and Yemen were successfully validated by the WHO as having achieved the elimination criteria in 2017 and 2019, respectively. In 2018, Sudan completed mapping of LF, reaching 26.2% geographical coverage where mass drug administration (MDA) is required and is scaling-up MDA. Extensive epidemiological assessment indicated the absence of LF transmission in the four suspected countries and no MDA required. Challenges faced during the elimination and post-elimination phases are described and discussed
more
In South and Central America, lymphatic filariasis (LF) is caused by Wuchereria bancrofti, which is transmitted by Culex quinquefasciatus, the only vector species in this region. Of the seven countries considered endemic for LF in the Americas in the last decade, Costa Rica, Suriname and Trinidad a
...
nd Tobago were removed from the World Health Organization list in 2011. The remaining countries, Brazil, Dominican Republic, Guyana and Haiti, have achieved important progress in recent years. Brazil was the first country in the Americas to stop mass drug administration (MDA) and to establish post-MDA surveillance. Dominican Republic stopped MDA in all LF-endemic foci: La Ciénaga and Southwest passed the third Transmission Assessment Survey (TAS) and the Eastern focus passed TAS-1 in 2018. Haiti passed the TAS and interrupted transmission in >80% of endemic communes, achieving effective drug coverage. Guyana implemented effective coverage in MDAs in 2017 and 2018 and in 2019 scaled up the treatment for 100% of the geographical region, introducing ivermectin in the MDA in order to achieve LF elimination by the year 2026. The Americas region is on its way to eliminating LF transmission. However, efforts should be made to improve morbidity management to prevent disability of the already affected populations.
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This document was prepared by UNICEF Regional Office for West and Central Africa, under the leadership of Christophe Valingot and the review of Joachim Peeters (WASH Specialist) and Arnaud Laillou (Nutrition Specialist), on behalf of the WASH Regional Group and the Nutrition Regional Group.
This
...
WASH - Nutrition strategic guidance note for West and Central Africa builds on the precedent WASH-in-NUT strategy elaborated in 2012 and is the regional outcome of a multiyear collaborative work conducted at country level between 2018 and 2022, in Mali, Niger, Nigeria Chad, Burkina Faso. This work is based on a strong multi-partner collaboration, involving national technical directorates of the water and sanitation sector as well as technical directorates of Health and Nutrition, civil society organizations, national and international NGOs as well as United Nations agencies.
This document can serve as a technical and strategic guide for any partner wishing to strengthen the intersectorality of WASH-Nutrition programmes. It presents the regional WASH & Nutrition context, a brief review of the latest scientific evidence, and proposes an integrated WASH-Nutrition programming framework adapted to the regional context of West and Central Africa. Beyond the implementation of programmes, this document also calls for the explicit and concrete inclusion of WASH-Nutrition integration into national policy documents.
more
As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination and intersecting factors remain pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma
...
and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
more
In 2005, the World Health Organization (WHO) recognized Chagas disease (CD; Trypanosoma cruzi infection) as a neglected tropical disease (NTD) [1] and included it into the global plan to combat NTDs [2]. The Target 3.3 of the United Nations Sustainable Development Goals (UN/SDG) aims at ending the e
...
pidemics of NTDs by 2030 [3]. Mother-to-child (congenital/connatal) transmission is currently the main mode of transmission of T. cruzi over blood transfusions and organ transplantations in vector-free areas within and outside Latin America (LA). Based on recent demonstrations that congenital transmission can be prevented [4–7], WHO has shifted its objective, in 2018, from control to elimination of congenital CD (cCD).
more
Countries are making progress toward the global goal of 95% of people living with HIV knowing their status by 2025. However, considerable gaps remain in achieving these goals globally. Men in high HIV burden settings and men from key populations in all settings are consistently less likely to know t
...
heir HIV status than women. Globally, 78% of men ages 15 years and older who are living with HIV are aware of their HIV status, compared with 86% of women with HIV of these ages.
Offering HIV testing services, including HIV self-testing, at formal and informal workplaces has emerged as an effective, acceptable and feasible approach for reaching men. A 2018 World Health Organization (WHO) and International Labour Organization (ILO) policy brief provides key guiding principles for HIVST implementation at workplaces. Building on the 2018 policy brief, this brief captures early experience with HIVST implementation at workplaces and discusses emerging approaches of sustainable financing that can be adapted for HIV self-testing at workplaces.
The primary audiences for this policy brief are ministries of health and labour, national HIV programmes, employers’ organizations, workers’ organizations (labour unions), enterprises, implementing partners, including civil society organizations, and health insurance agencies.
more
The new WHO recommendations for rabies immunization supersede the 2010 WHO position
on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for rabies. These updated
recommendations are based on new evidence and directed by public health needs that are cost-,
dose- and time-sparing
...
, while assuring safety and clinical effectiveness. In addition, new guidance on
prudent use of rabies immunoglobulins (RIG) is provided.
The following sections summarize the main points of the updated WHO position as endorsed by the
Strategic Advisory Group of Experts on immunization (SAGE) at its meeting in October 20171. The full
version of the WHO position on rabies vaccines and immunoglobulins will be published in the Weekly
Epidemiological Record2 in April 2018.
Rabies prevention involves two main strategies: (i) dog vaccination to interrupt virus transmission to
humans; and (ii) human vaccination as a series of vaccine administrations before or after an exposure.
Currently, rabies vaccines made from inactivated cell cultures are extremely well tolerated and have no
contraindications.
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African regional progress and status of the programme to eliminate lymphatic filariasis: 2000–2020
Deribe K., Bakajikaa D. K., Zourea H. MG. et al
The royal society of tropical medicine and hygiene
(2021)
C2
To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Afric
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a through the WHO neglected
tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme
in the region while we identify the key remaining challenges in achieving an Africa free of LF.
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Community-Based Interventions for the Prevention and Control of Cutaneous Leishmaniasis
Polidano, K.; Wenning, B.; Ruiz-Cadavid. et al
Multidisciplinary Digital Publishing Institute MDPI
(2022)
CC
Cutaneous leishmaniasis (CL) is a parasitic disease caused by infection with a vector-borne protozoan parasite of the genus Leishmania spp. The parasite is transmitted by the bite of an infected phlebotomine sand fly. Infection results in skin lesions which take a long time to heal and may leave per
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manent, disfiguring scars (de Vries et al. 2015). CL is classified as a neglected tropical disease (NTD), and in common with several other NTDs, is associated with psychosocial effects including stigma, social exclusion, and declining mental health (Bailey et al. 2019; Bennis et al. 2018; Wenning et al. 2022). Emerging evidence suggests that people with CL are at a higher risk of experiencing anxiety, depression, decreased body satisfaction, loss of social status, and lower quality of life (Bennis et al. 2018; Yanik et al. 2004). The global mean age-standardised disability-adjusted life years (DALYs) lost by CL was 0.58 per 100,000 people (Karimkhani et al. 2016). Notably, this statistic only considers the physical effects of the lesions and does not account for the potentially considerable psychological and social effects of CL (Bailey et al. 2017; Bailey et al. 2019; Wenning et al. 2022).
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The Event-based Surveillance Framework is intended to be used by authorities and agencies responsible for
surveillance and response. This framework serves as an outline to guide stakeholders interested in implementing
event-based surveillance (EBS) using a multisectoral, One Health approach. To
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that end, the document is arranged
in interlinked chapters and annexes that can be modified and adapted, as needed, by users.
This is a revised version of the original “Framework for Event-based Surveillance” that was published in 2018. This
framework does not replace any other available EBS materials, but rather builds on existing relevant or related
documents and serves as a practical guide for the implementation of EBS in Africa. This framework is aligned with
the third edition of the WHO Joint External Evaluation for the following indicators: strengthened early warning
surveillance systems that are able to detect events of significance for public health and health security (Indicator
D2.1); improved communication and collaboration across sectors and between National, intermediate and local
public health response levels of authority regarding surveillance of events of public health significance (Indicator
D2.2); and improved national and intermediate-level capacity to analyse data (Indicator D2.3). As countries begin
to implement and demonstrate EBS functionality they will ensure an increase in JEE scores and progress towards
meeting the requirements outlined in the IHR3F
Additionally, in African Union Member States that have adopted the Integrated Disease Surveillance and
Response (IDSR) strategy, this document is a complement to and can enhance the implementation of IDSR,
especially for the 3rd edition (2019) that includes components related to EBS.
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Le cadre de surveillance basé sur les événements est destiné à être utilisé par les autorités et les
agences responsables de la surveillance et de l'intervention. Ce cadre sert de cadre pour guider les
parties prenantes intéressées par la mise en œuvre de la surveillance basée sur le
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s événements (SBÈ)
en utilisant une approche multisectorielle axée sur l'approche « Une seule santé ». À cette fin, le
document est organisé en chapitres et annexes interconnectés qui peuvent être modifiés et adaptés,
selon les besoins, par les utilisateurs.
Il s'agit d'une version révisée du « Cadre pour la surveillance basée sur les événements » original qui
a été publié en 2018. Ce cadre ne remplace aucun autre matériel SBÈ disponible, mais s'appuie plutôt
sur des documents pertinents ou connexes existants et sert de guide pratique pour la mise en œuvre
de l'SBÈ en Afrique. Ce cadre est conforme à la troisième édition de l'évaluation externe conjointe de
l'OMS pour les indicateurs suivants : systèmes d'alerte précoce renforcés capables de détecter les
événements importants pour la santé publique et la sécurité sanitaire (indicateur D2.1) ; amélioration
de la communication et de la collaboration entre les secteurs et entre les niveaux d'autorité nationaux,
intermédiaires et locaux d'intervention en matière de santé publique en matière de surveillance des
événements importants pour la santé publique (indicateur D2.2) ; et amélioration de la capacité
d'analyse des données aux niveaux national et intermédiaire ( Indicateur D2.3). Au fur et à mesure
que les pays commenceront à mettre en œuvre et à démontrer la fonctionnalité SBÈ, ils garantiront
une augmentation des scores EEC et des progrès vers le respect des exigences décrites dans l'RSI
(Règlement sanitaire international).
En outre, dans les États membres de l'Union africaine qui ont adopté la Surveillance et réponse
intégrées aux maladies (SRIM), ce document complète et peut améliorer la mise en œuvre de l'SRIM,
en particulier pour la 3e édition (2019) qui inclut des composants liés à l'SBÈ.
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A Estrutura de Vigilância Baseada em Eventos deve ser usada por autoridades e agências responsáveis
pela vigilância e resposta. Essa estrutura serve como um esboço para orientar as partes interessadas
em implementar a vigilância baseada em eventos (EBS) usando uma abordagem multissetorial
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de One
Health. Para esse fim, o documento é organizado em capítulos e anexos interligados que podem ser
modificados e adaptados, conforme necessário, pelos usuários.
Esta é uma versão revisada da “Estrutura para Vigilância Baseada em Eventos” original, publicada em
2018. Essa estrutura não substitui nenhum outro material disponível do EBS, mas se baseia em
documentos relevantes ou relacionados existentes e serve como um guia prático para a
implementação do EBS na África. Essa estrutura está alinhada com a terceira edição da Avaliação
Externa Conjunta da OMS para os seguintes indicadores: sistemas de vigilância de alerta precoce
fortalecidos que são capazes de detectar eventos importantes para a saúde pública e a segurança da
saúde (Indicador D2.1); melhor comunicação e colaboração entre os setores e entre os níveis de
autoridade de resposta à saúde pública nacional, intermediário e local em relação à vigilância de
eventos importantes para a saúde pública (Indicador D2.2); e melhor capacidade nacional e
intermediária de analisar dados ( Indicador D2.3). À medida que os países começarem a implementar
e demonstrar a funcionalidade do EBS, eles garantirão um aumento nas pontuações do JEE e
progredirão no cumprimento dos requisitos descritos no IHR 3F.
.
Além disso, nos Estados Membros da União Africana que adotaram a estratégia Integrada de
Vigilância e Resposta a Doenças (IDSR), este documento é um complemento e pode aprimorar a
implementação do IDSR, especialmente para a 3ª edição (2019), que inclui componentes
relacionados ao EBS.
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Soil transmitted helminth (STH) infections are among the most common human infections worldwide with over 1 billion people affected. Many estimates of STH infection are often based on school-aged children (SAC). This study produced predictive risk-maps of STH on a more finite scale, estimated the nu
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mber of people infected, and the amount of drug required for preventive chemotherapy (PC) in Ogun state, Nigeria. Georeferenced STH infection data obtained from a cross-sectional survey at 33 locations between July 2016 and November 2018, together with remotely-sensed environmental and socio-economic data were analyzed using Bayesian geostatistical modelling. Stepwise variable selection procedure was employed to select a parsimonious set of predictors to predict risk and spatial distribution of STH infections. The number of persons (pre-school ages children, SAC and adults) infected with STH were estimated, with the amount of tablets needed for preventive chemotherapy. An overall prevalence of 17.2% (95% CI 14.9, 19.5) was recorded for any STH infection. Ascaris lumbricoides infections was the most predominant, with an overall prevalence of 13.6% (95% CI 11.5, 15.7), while Hookworm and Trichuris trichiura had overall prevalence of 4.6% (95% CI 3.3, 5.9) and 1.7% (95% CI 0.9, 2.4), respectively. The model-based prevalence predictions ranged from 5.0 to 23.8% for Ascaris lumbricoides, from 2.0 to 14.5% for hookworms, and from 0.1 to 5.7% for Trichuris trichiura across the implementation units. The predictive maps revealed a spatial pattern of high risk in the central, western and on the border of Republic of Benin. The model identified soil pH, soil moisture and elevation as the main predictors of infection for A. lumbricoides, Hookworms and T. trichiura respectively. About 50% (10/20) of the implementation units require biannual rounds of mass drug administration. Approximately, a total of 1.1 million persons were infected and require 7.8 million doses. However, a sub-total of 375,374 SAC were estimated to be infected, requiring 2.7 million doses. Our predictive risk maps and estimated PC needs provide useful information for the elimination of STH, either for resource acquisition or identifying priority areas for delivery of interventions in Ogun State, Nigeria.
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SDG Costing & Financing for Low-Income Developing Countries
Sachs, J.; G. McCord; N. Maennling et al.
UN Sustainable Development Solutions Network (SDSN)
(2019)
CC
The Sustainable Development Goals (SDGs) call for major societal transformations that will require significant fiscal outlays as well as private investments. The fiscal outlays cover public investments, the public provision of social services, and social protection for vulnerable populations. The ke
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y message of this paper, building on recent reports by the IMF and SDSN (IMF, 2019b; SDSN, 2018) is that the governments of Low-Income Developing Countries (LIDCs) will require a substantial increase in fiscal (budget) revenues, far beyond what they can achieve by their own fiscal reforms. For this reason, SDG financing will require substantial international cooperation to enable the LIDCs to finance their SDG fiscal outlays. One important source of increased revenues should be the globally coordinated taxation of ultra-high-net worth assets. Today’s ultra-rich should help to pay for the survival and basic needs of the world’s poorest people.
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This publication presents a framework to implement the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda) that is structured around essential public health functions focused on environmental determinants of health. The Agenda is a call to action to the health
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sector to lead the charge to address environmental determinants of health in the Americas. The Pan American Health Organization (PAHO) will work with Member States to achieve its goal and objective to ensure healthy lives and promote well-being for all at all ages using a sustainable and equitable approach that places a priority on reducing health inequity. The Agenda was developed under the umbrella of the WHO Global Strategy on Health, Environment, and Climate Change, and builds upon the commitments set forth in the Sustainable Health Agenda for the Americas 2018–2030 and the PAHO Strategic Plan 2020–2025.
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This publication describes the history of malaria in Uzbekistan. It evaluates the policies and strategies applied after the re-establishment of local transmission to contain malaria outbreaks in the 1990s and early 2000s, and highlights the interventions subsequently used to eliminate malaria in the
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country. Uzbekistan was officially certified by WHO as a malaria-free country in 2018. Lessons for countries embarking upon elimination are distilled. The publication is intended for health managers and personnel, researchers, teachers, students and post-graduates at medical schools.
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La fascioliasis es una enfermedad parasitaria que afecta a las personas y a una gran variedad de animales, esencialmente herbívoros. En América Latina y el Caribe está causada por el trematodo Fasciola hepatica. La fascioliasis está clasificada por la Organización Mundial de la Salud (OMS) dent
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ro de las enfermedades tropicales desatendidas. La Organización Panamericana de la Salud, como parte del compromiso para lograr las metas de la Agenda 2030 para el Desarrollo Sostenible y la Agenda de Salud Sostenible para las Américas 2018-2030, lanzó una iniciativa de eliminación de las enfermedades transmisibles en la Región de las Américas, que incluye entre sus objetivos eliminar la fascioliasis como un problema de salud pública en la Región de las Américas para el año 2030.
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Background
The objective of this study was to investigate the effects of reduction, cessation, and resumption of smoking on cancer development.
Methods
The authors identified 893,582 participants who currently smoked, had undergone a health screening in 2009, and had a follow-up screening in 20
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11. Among them, 682,996 participated in a third screening in 2013. Participants were categorized as quitters, reducers I (≥50% reduction), reducers II (<50% reduction), sustainers (referent), or increasers (≥20% increase). Outcome data were obtained through December 31, 2018.
Results
Reducers I exhibited a decreased risk of all cancers (adjusted hazard ratio [aHR], 0.96; 95% confidence interval [CI], 0.93-0.99), smoking-related cancers (aHR, 0.95; 95% CI, 0.92-0.99), and lung cancer (aHR, 0.83; 95% CI, 0.77-0.88). Quitters had the lowest risk of all cancers (aHR, 0.94; 95% CI, 0.92-0.96), smoking-related cancers (aHR, 0.91; 95% CI, 0.89-0.93), and lung cancer (aHR, 0.79; 95% CI, 0.76-0.83). In further analysis with 3 consecutive screenings, additional smoking reduction (from reducers II to reducers I) lowered the risk of lung cancer (aHR, 0.74; 95% CI, 0.58-0.94) in comparison with sustainers. Quitting among reducers I further decreased the risk of all cancers (aHR, 0.90; 95% CI, 0.80-1.00), smoking-related cancers (aHR, 0.81; 95% CI, 0.81-0.92), and lung cancer (aHR, 0.66; 95% CI, 0.52-0.84) in comparison with sustainers. Smoking resumption after quitting, even at a lower level, increased the risk of smoking-related cancers (aHR, 1.19; 95% CI, 1.06-1.33) and lung cancer (aHR, 1.48; 95% CI, 1.21-1.80) in comparison with sustained quitting.
Conclusions
Smoking cessation and, to a lesser extent, smoking reduction decreased the risks of cancer. Smoking resumption increased cancer risks in comparison with sustained quitting.
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Social protection, a component of the World Health Organization (WHO)’s End TB strategy, has been upheld by Member States as an essential part of the response to tuberculosis in several political declarations, including the 2017 Moscow Declaration to End TB, and both the political declarations of
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both the 2018 and 2023 United Nations General Assembly (UNGA) high-level meetings on the fight against TB. Furthermore, during the 2023 high-level meeting, member states agreed on a new target to ensure that all people with TB have access to a comprehensive package of health and social benefits by 2027.
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