These consolidated guidelines on HIV testing services (HTS) bring together existing and new guidance on HTS across different settings and populations.
The World Health Organization (WHO) first released consolidated guidelines on HTS in 2015, in response to requests from Member States, national pr...ogramme managers and health workers for support to achieve the United Nations (UN) 90–90–90 global HIV targets – and specifically the first target of diagnosing 90% of all people with HIV. In 2016, based on new evidence, WHO released a supplement to address important new HIV testing approaches – HIV self-testing (HIVST) and provider-assisted referral.
Since the release of 2015 and 2016 HTS guidelines, new issues and more evidence have emerged. To address this, WHO has updated guidance on HIV testing services. In this guideline, WHO updates recommendation on HIVST and provides new recommendations on social network-based HIV testing approaches and western blotting (see box, next page). This guideline seeks to provide support to Member States, programme managers, health workers and other stakeholders seeking to achieve national and international goals to end the HIV epidemic as a public health threat by 2030.
These guidelines also provide operational guidance on HTS demand creation and messaging; implementation considerations for priority populations; HIV testing strategies for diagnosis HIV; optimizing the use of dual HIV/syphilis rapid diagnostic tests; and considerations for strategic planning and rationalizing resources such as optimal time points for maternal retesting
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This document aims to provide guidance to EU/EEA public health authorities, public health professionals and healthcare practitioners for the management of persons having had contact with cases of Ebola virus disease (EVD) after visiting or working in an area that is affected by EVD; also covered is ...occupational exposure to the disease
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National HIV Strategic Plan 2016-2021
With the goal of ending viral hepatitis as a public health threat by 2030, the Regional Action Plan will provide an actionable framework for implementing evidence-based interventions at scale. It will be informed through strategic monitoring of the response, that must be equitable and sustainable an...d allow for innovations for acceleration and reaching out to all in need with health services. A major reduction in prices of newer drugs to potentially cure hepatitis C offers an added opportunity to work towards its elimination.
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"Some of the problems with our current drug policies stem from the fact that these policies have been largely bifurcated between two different and often contradictory approaches. One treats drug use as a crime that cannot be tolerated and should be punished; the other views addiction as a chronic re...lapsing health or behavioral condition requiring ongoing treatment and support. Neither of these views is all encompassing—it should be recognized that there are patterns of drug use that do not result in significant harm or health problems and therefore require no intervention. The public health approach presented here takes the view that our focus should be on the harm caused by drug use and the harm caused by our policy responses to it. We have focused specifically on illicit drugs, not because they are by themselves more harmful (in fact, tobacco causes more morbidity and mortality than any illicit drug), but because it has become increasingly clear that our current policies to manage illicit drugs are failing."
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Social distancing is an action taken to minimise contact with other individuals; social distancing measures comprise one category of non-pharmaceutical countermeasures (NPCs)1 aimed at reducing disease transmission and thereby also reducing pressure on health services.
This document builds upon exi...sting ECDC documents, including guidelines for the use of non-pharmaceutical measures to delay and mitigate the impact of 2019-nCoV, a rapid risk assessment: outbreak of novel coronavirus disease – 5th update, a technical report on the use of evidence in decision-making during public health emergencies, and a guidance document on community engagement for public health events caused by communicable disease threats in the EU/EEA.
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The spread of antimicrobial-resistant microorganisms poses anincreasing threat to affordable modern health care. In the Netherlands, efforts to control the dispersal of known and novel antimicrobial-resistant organisms have been mostly implemented at the hospital level. However, recent studies have ...recommended shifting the focus of control strategies fromsingle hospitals toward larger healthcare networks. These networks consist of clusters of hospitals that are connected viashared patients. Several studies have shown that patients transferred from one hospital to another can spread antimicrobial-resistant pathogens across the healthcare network
infection control & hospital epidemiology july 2016, vol. 37, no. 7
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The escalating antimicrobial resistance (AMR) pandemic is a global public health threat with extensive health, economic and societal implications. Resistance emerges because of selection pressure from rational and indiscriminate antimicrobial use in human health as well as in the veterinary, agricul...ture and environmental sectors. Infections caused by resistant bacteria result in longer duration of illness, higher mortality rates and increased costs associated with alternative treatment. AMR further constrains procedures that rely on antimicrobial prophylaxis, and AMR is recognized as a threat to theworld economy.
Journal of Public Health | Vol. 39, No. 1, pp. 8–13 | doi:10.1093/pubmed/fdw015 | Advance Access Publication March 3 2016
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Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance wh...ile maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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In the current absence of vaccine for COVID-19, public health response target breaking the chain of infection by focusing on the mode of transmission. This paper summarizes current evidence-base around the transmission dynamics, pathogenic, and clinical features of COVID-19, to critically identify i...f there are any gaps in the current IPC guidelines.
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he pandemic has produced an unprecedented economic and social crisis, and it could generate a food, humanitarian, and political crisis if urgent measures are not taken. The policy options for addressing the pandemic entail consolidating national plans and achieving intersectoral consensus. The respo...nse should be structured in three nonlinear and interrelated phases—control, reactivation, and rebuilding—involving the participation of technical actors representing not only the field of health but also other social and economic areas. Measures implemented to control the pandemic as well as measures for the reactivation and rebuilding phases will require increased public investment in health until the recommended parameters are achieved.
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This updated step by step guide aims to assist the ministries of health (MoHs) in developing the national action plans for noma prevention and control, with a view to sustainably reducing the incidence of noma as a public health problem through programmes that are fully integrated with national heal...th planning, strengthening of primary health care (PHC) and attainment of universal health coverage (UHC).
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp...onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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The threat climate change poses to health, equity, and development has been rigorously documented. However, in an era marked by economic crisis, regional conflicts, natural disasters and growing disparities between rich and poor, the joint global actions required to address climate change have been ...vigorously debated – and critical decisions postponed.
This document, part of WHO’s Health in the Green Economy series, describes how many climate change measures can be “win-wins” for people and the planet.
These policies yield large, immediate public health benefits while reducing the upward trajectory of greenhouse gas emissions. Many of these policies can improve the health and equity of people in poor countries and assist developing countries in adapting to climate change that is already occurring, as evidenced by more extreme storms, flooding, drought and heatwaves.
WHO’s Department of Public Health and Environment launched the Health in the Green Economy initiative in 2010 to review potential health and equity “co-benefits” of proposed climate change measures – as well as relevant risks.
This review examines mitigation strategies discussed in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change which constitutes the most broad-based global review of mitigation options by scientific experts.
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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control in these communities, it is necessary to respond t...o communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduce clinical variability and, in essence, improve hea...lth and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
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The Transformation Agenda (TA) ushered in an ambitious reform process intended to transform the World Health Organization (WHO) into an organization that is proactive, results-driven, accountable and which meets stakeholder expectations, towards transforming and improving public health services in t...he African Region. It aimed to achieve a WHO that is pro-results, which optimally and creatively targets technical work as well as make operations more responsive, with greater effectiveness in both communications and partnerships. The Africa Region has been the epicentre of the human immunodeficiency virus (HIV) epidemic and it’s one of the leading causes of disease and death on the continent. The WHO, with partners, has worked tirelessly for many years to control the threat and reduce the negative impact of the disease. Since the early 2000s, significant progress has been made in the global fight against the scourge of HIV. However, the WCA subregion was falling concerningly behind ESA on several key indicators of progress. In 2016, the WHO joined UNAIDS, UNICEF and other partners in a call for a strong and urgent response to support WCA countries to develop catch-up plans to triple and fast-track ART coverage, to enable the region to catch up with ESA by the end of 2020. Implementation of a widespread test-and-treat strategy, coupled with the scale-up of differentiated service delivery (DSD) and mobilization of requisite funding, accelerated WCA’s progress towards this goal. The HIV treatment catch-up and fast-track plan has achieved its target of seeing the West and Central African region (WCA) catch up with the Eastern and Southern African region’s (ESA) antiretroviral coverage rate of 78% in 2021, albeit later than the 2020 target time frame. A 33% improvement was achieved in WCA, against 21% in ESA, between 2015–2020. WCA achieved a significant 42% increase, compared to ESA’s 23%, between 2015 and 2021, to see WCA draw level with ESA at 78%. In the Democratic Republic of the Congo (DRC) alone, progress of up to 47% was observed between 2015 and 2020, for example. In addition, 1.6 million more People Living with HIV (PLHIV) were enrolled on antiretroviral treatment (ART) between 2015 and 2020.
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The importance of robust mortality surveillance systems cannot be overstated in an era marked by increasing global health challenges where health threats loom large and population dynamics continue to evolve. Accurate and timely mortality data is essential for identifying trends and detecting emergi...ng health threats, evaluating the impact of interventions, and guiding evidence-based policy decisions.
This framework outlines a holistic approach to strengthening routine mortality surveillance systems, considering the unique contextual factors and challenges faced by African countries. It emphasizes the importance of establishing efficient data collection mechanisms, enhancing data quality and completeness, and promoting data sharing and collaboration among stakeholders.
Moreover, the framework recognizes the pivotal role of technology in the integration of data from fragmented mortality data sources. It highlights the potential of innovative data capture methods, advanced analytics, and real-time reporting systems to enhance mortality data’s accuracy, efficiency, and timeliness.
The continental framework for mortality surveillance aligns with Africa CDC’s mission and strategic goal by serving as a fundamental component in strengthening public health systems, enhancing disease surveillance capacities and capabilities, informing evidence-based policies and interventions, and promoting collaboration and coordination among African countries to address health challenges and improve health outcomes on the continent.
The successful implementation of this framework requires collective commitment and concerted efforts from governments, health institutions, and the international community. We hope this document will serve as a catalyst for transformative change, enabling countries to build resilient mortality surveillance systems that protect public health, save lives, and contribute to evidence-based decision-making.
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This resource pack was developed for the country offices of the World Health Organization and national Public Health institutions, as an overview of the key information needed for advising their Member States in response to questions raised on human health due to influenza outbreaks or detections in... animals. It assembles the available information from WHO, FAO and WOAH, on recommendations and guidelines on influenza that might be relevant to a country experiencing detections or outbreaks of influenza in animals or facing suspicion of human infections with animal-origin influenza viruses. This resource pack updates the information provided in the Summary of Key Information Practical to Countries Experiencing Outbreaks of A(H5N1) and Other Subtypes of Avian Influenza, published in 2016. Additionally, the scope of this current document was broadened to address the risks to public health from all animal influenza viruses, not only avian influenza. Links to existing resources were updated and new resources were added where available.
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Cholera remains a significant public health threat in many countries worldwide. In resource-constrained settings, it disproportionately affects thousands of poor and vulnerable population