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1
Sexual abuse perpetrated against children is one of the most significant crises of our time. Child sexual abuse is a significant risk factor for children, in common with other forms of child maltreatment. Sexual abuse can have severe short- and long-term consequences on the physical, mental, social,
...
emotional and economic well-being of children, families and communities. In emergencies, the threat of all forms of child abuse and gender-based violence (GBV), including child sexual abuse, is acute and widespread.
more
The ERF provides WHO staff with essential guidance on how the Organization manages the assessment, grading and response to public health events and emergencies with health consequences, in support of Member States and affected communities. The ERF adopts an all-hazards approach and it is therefore a
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pplicable in all acute public health events and emergencies.
This version (2024) of the WHO ERF has been developed following extensive consultation across the three levels of the Organization and response experiences over the last five years of emergency response. Key areas have been updated to improve the accountability, predictability, timeliness and effectiveness of WHO’s response to emergencies.
more
Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a
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t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
more
After introducing Ethiopia's WASH sector challenges and trends, the plan describes IRC Ethiopia's vision and strategy which draws from IRC and Water For People's joint framework - Destination 2030. It then details the organisational changes and business development needed to implement the strategic
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plan. Detailed targets are provided in the annexes.
At IRC, we believe that turning on a working tap should not be a surprise or cause for celebration. We believe in a world where water, sanitation and hygiene services are fundamental utilities that everyone is able to take for granted. For good.
We face a complex challenge. Every year, thousands of projects within and beyond the WASH sector fail – the result of short-term targets and interventions, at the cost of longterm service solutions.
This leaves around a third of the world’s poorest people without access to the most basic of human rights, and leads directly to economic, social and health problems on a global scale. IRC exists to continually challenge and shape the established practices of the WASH sector.
Through collaboration and the active application of our expertise, we work with governments, service providers and international organisations to deliver systems and services that are truly built to last.
more
Mental health problems are common and cause great suffering to individuals and communities around the world. They have a significant impact not only on the physical and mental health of those affected but also on their families and the communities they live in. At the same time, all communities have
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their own traditional mechanisms for support and contain a range wide of resources that can be helpful in preventing mental health conditions from developing, promoting positive mental health and supporting the recovery of people that are struggling with a mental health condition.
In the wider context, people living with a mental health condition are often excluded from their communities and experience various violations to their basic human rights (discrimination, violence, exclusion from employment opportunities). The World Health Organization (WHO) estimates that the mean prevalence of global mental health disorders is 10.8% while the prevalence in emergency settings is 22.1% in any conflict-affected population.
During emergencies and crisis, the stigma, exclusion and discrimination towards people living with mental health conditions is often higher, which can cause isolation and protection issues. Communities can play a crucial role in promoting mental health as well as enhancing primary care and access. Their role is to help reduce mental health inequalities by providing community resources that connect people to community-based resources and by providing mental health education. This also helps to reduce the massive mental health treatment gap.
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The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health outcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases
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, injuries and risk factors in more than 200 countries and territories and at the subnational level in more than 20 countries. The GBD is now produced by an active collaboration of over 8,000 scientists and analysts from more than 150 countries. With each GBD iteration, the data, data processing and methods used for data synthesis have evolved, with the goal of enhancing transparency and comparability of measurements and communicating various sources of uncertainty. The GBD has many limitations, but it remains a dynamic, iterative and rigorous attempt to provide meaningful health measurement to a wide range of stakeholders.
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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 (NE
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MLs) of LMICs and potential determinants for selection.
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As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive protection for individuals across the lifespan. By adopt
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ing a life course approach (LCA) to immunization, vaccination programs can be tailored to close immunity gaps at different stages of life. The life course approach foresees the establishment of multiple strategies to reduce missed opportunities for vaccination according to age group. This technical document explains the key concepts of the LCA with a focus on immunization by vaccination, as well as the underlying biological mechanisms that require the application different vaccines at different life stages according to changes to the immune system and in the epidemiological situation of a community.
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Protection from a Single Dose of HPV Vaccine A major public health impact from IARC studies of vaccine efficacy.
The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The
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Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex. It also includes a summary of the countries health systems’ response to diabetes, including national plans, targets, surveillance, guidelines, and access to essential drugs and technologies, and synthesizes information about diabetes-related complications and the close relationship between diabetes and other pathologies, such as cardiovascular diseases, tuberculosis, and COVID-19. The data presented here reveal that, despite advances in national responses, diabetes continues to expand, and our response remains insufficient. This report aims to draw attention to the urgent need to strengthen efforts to prevent, diagnose, and control diabetes in the Region of the Americas.
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Strategic communication is at the heart of public health and more important than ever in the digital age. Using communication strategically requires expertise, skills and resources to plan, implement and evaluate interventions that encourage governments to implement policies that improve people’s
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lives and well-being, that empower health workers to deliver the best care possible, and that encourage people to take actions that protect and improve their health and that of their family and community. This Regional Action Framework on Communication for Health (C4H) aims to support Member States in implementing the C4H approach. It outlines steps to be taken by WHO and Member States to use C4H to achieve shared public health goals in the Western Pacific.
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The purpose of this workbook is to assist ministries of health, health managers and practitioners in engaging with the private sector on delivery of quality maternal, newborn and child health (MNCH) services in lower- and middle-income countries. Private health care is one of the fastest growing seg
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ments of the health-care system in lower- and middle-income countries, and private providers are an important source of health care. To accelerate progress to reach the Sustainable Development Goals for ending preventable maternal, newborn and child deaths, it is critical that whole health system organizations invest not only in increasing coverage of interventions, but also in quality. The audience for the workbook is those who are involved with organizing and implementing processes for engaging the private sector in delivery of quality MNCH services.
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Evidence-based psychological interventions are an important part of health, social, protection and education services and can help increase access to effective mental health treatments and progression towards universal health coverage.
This manual provides managers and others responsible for plan
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ning and delivering services with practical guidance on how to implement manualized psychological interventions for adults, adolescents and children. It covers the five key implementation steps: make an implementation plan; adapt for context; prepare the workforce; identify, assess and support potential beneficiaries; and monitor and evaluate the service.
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While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challeng
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es, including misdiagnosis and access to insulin, can affect T1D outcomes and frequency of severe complications. Despite the severe nature of T1D and growing burden in subSaharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region. Methods We conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and selfmanagement, and barriers and facilitators for accessing T1D care.
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At the global, national, and regional levels, there are several guidelines and guides regarding the preparedness, prevention, surveillance, and control of diseases caused by respiratory viruses; most initiatives focus on specific virus events or cases. During the coronavirus disease 2019 (COVID-19)
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pandemic, it has been found that even when there are strategies designed and planned for pandemics, it is necessary to strengthen and improve them. Planning for imminent threats, including those posed by respiratory viruses, contributes to strengthening the core capacities of the International Health Regulations (IHR [2005])
more
Heart and circulatory diseases is an umbrella term for all diseases of the heart and circulation. It includes everything from conditions that are inherited or that a person is born with, to those that develop later, such as coronary heart disease, atrial fibrillation, heart failure, stroke and vascu
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lar dementia.
more
Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera
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lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
more
Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 202
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1 to 784 million by 2045.1 As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030.2 Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
more
State of the Climate in Asia 2023
recommended
Asia remained the world’s most disaster-hit region from weather, climate and water-related hazards in 2023. Floods and storms caused the highest number of reported casualties and economic losses, whilst the impact of heatwaves became more severe, according to a new report from the World Meteorolog
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ical Organization (WMO).
The State of the Climate in Asia 2023 report highlighted the accelerating rate of key climate change indicators such as surface temperature, glacier retreat and sea level rise, which will have major repercussions for societies, economies and ecosystems in the region.
In 2023, sea-surface temperatures in the north-west Pacific Ocean were the highest on record. Even the Arctic Ocean suffered a marine heatwave.
Asia is warming faster than the global average. The warming trend has nearly doubled since the 1961–1990 period.
more
Patients with diabetes are at increased risk of developing cardiovascular disease (CVD) with its manifestations of coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and stroke, as well as aortic and peripheral artery diseases. In addition, diabetes is a major risk factor f
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or developing chronic kidney disease (CKD), which in itself is associated with developing CVD. The combination of diabetes with these cardio-renal comorbidities enhances the risk not only for cardiovascular (CV) events but also for CV and all-cause mortality. The current European Society of Cardiology (ESC) Guidelines on the management of cardiovascular disease in patients with diabetes are designed to guide prevention and management of the manifestations of CVD in patients with diabetes based on data published until end of January 2023. Over the last decade, the results of various large cardiovascular outcome trials (CVOTs) in patients with diabetes at high CV risk with novel glucose- lowering agents, such as sodium–glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), but also novel non-steroidal mineralocorticoid receptor antagonists (MRAs), such as finerenone have substantially expanded available therapeutic op-
tions, leading to numerous evidence-based recommendations for the management of this patient population.
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