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 essentia...l for creating an environment that supports the dignity 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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The community-BFCI (c-BFCI) manual has been developed to facilitate training of CHVs and stakeholders providing nutrition sensitive services at community level. The manual covers a wide range of topics: basic nutrition, exclusive breastfeeding, complementary feeding, Breast Milk Substitutes Act, gro...wth monitoring and promotion, early childhood development and stimulation, household food and nutrition security and establishment of baby friendly communities.
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The community-BFCI (c-BFCI) manual has been developed to facilitate training of CHVs and stakeholders providing nutrition sensitive services at community level. The manual covers a wide range of topics: basic nutrition, exclusive breastfeeding, complementary feeding, Breast Milk Substitutes Act, gro...wth monitoring and promotion, early childhood development and stimulation, household food and nutrition security and establishment of baby friendly communities.
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Health in All Policies (HiAP) is not a new concept. While the term “HiAP” has received much attention since the 1990s, the concept
of working across sectors of government for improved populatio...n health and wellbeing is much older than that. Over the last few decades the term has been applied to multiple health topics and challenges – whetherimplicitly or explicitly.
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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro...bial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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In 2015, 26% of the deaths of 5.9 million children who died before reaching their fifth birthday could have been prevented
through addressing environmental risks – a shocking missed opportunity. The prenatal and early childhood period represents
a window of particular vulnerability, where enviro...nmental hazards can lead to premature birth and other complications,
and increase lifelong disease risk including for respiratory disorders, cardiovascular disease and cancers. The environment
thus represents a major factor in children’s health, as well as a major opportunity for improvement, with effects seen in every
region of the world.
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Children expressed the need for organisations to
support in the delivery of services such as health and
sanitation. The children also emphasized ...that schools
and the child-friendly spaces (CFSs) were effective
and important spaces to provide them with what they
need.
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The greatest risk to persons engaging in international medical emergency response is poor preparation.
The In Control handbook hopes to provide a remedy.
At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health...n> emergency that disregards physical borders, brings into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated.
Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all.
The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world.
The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards.
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Together for One Health. Building on the momentum of increased collaboration, the WHO, FAO, OIE and UNEP have developed a Strategic Framework for c...ollaboration on antimicrobial resistance (AMR). This Framework reflects the joint work of the four organizations to advance a One Health response to AMR at the global, regional and country level. It broadly supports the implementation of the five pillars of the Global Action Plan on AMR, as well as strengthening global AMR governance.
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The most significant finding of the case study for integrating antimicrobial resistance (AMR)into existing programs and mobilising resources for funding in Nigeria, is that most of the AM...R activities within the Nigerian National Action Plan (NAP)canalready be incorporated within existing programs of the Federal Ministry of Health (FMOH), Federal Ministry of Agriculture and Rural Development (FMARD) and their agencies or institutes. Certain programs and initiatives already have an AMR element incorporated or could,with little effort,include some additional AMR actions, however much is already being planned and has started with existing federal funding and existing staffing and other resources including development partner support and is being driven by significant political will from the ministries as well as implementation support from the Nigerian Centers for Disease Control as the focal point.
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The purpose of this document is to provide interim guidance to laboratories and stakeholders involved in laboratory testing for Middle East respiratory syndrome coronavirus (MERS-CoV).
A concept (leaflet)
This document outlines the concept of a stimulus package for rabies elimination. The aim of a stimulus package is to catalyse rabies control by starting community projects, building local capacity and using success to genera...te momentum for growth. Governments could apply for a package, which would provide technical and material support to run small, successful rabies control projects. These in turn build evidence for the feasibility of larger scale elimination, generate enthusiasm foaction and promote investment for sustainability and up scaling. Data reporting in return for the packages would allow the documentation of successes and lessons learnt to benefit global elimination efforts more broadly.
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The messages should be used to inform, educate and engage different audience groups depending on their level of risk, vulnerability, presence in contact areas, care of patients with Ebola, or engagement or attendance of burials.
WHO strongly recommends discontinuation of the nerve tissue vaccine, and replacement with modern concentrated and purified cell culture derived vaccines (CCDV) and embryonated eggbased rabies vaccines.
These vaccines must comply with WHO criteria for...n> potency and innocuity following satisfactory assessment in humans during well-designed field trials
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The Ghanaian Cabinet approved the antimicrobial resistance (AMR)Policy and Implementation plan(hereafter referred to as the national action plan or NAP)in December 2017, whilst the country case study was in progress. This has set in motion the implementation phase ...t medbox">for Ghana, which is a long awaited event since the drafting of the Policy started in 2011. This case study, whilst limited in its ability to interact with all stakeholders, has identified entrypoints within the operational divisions of Ghana Health Services,as potential areas where the AMR policy platform may seek to embed AMR activities. Much work has already been done within Ghana to identify the key entrypoints within the various ministries and government agencieswhere AMR can be incorporated. These stakeholders already form part of the AMR Policy Platform which is the governance structure for AMR and have been participating actively in the development of the AMR Policy and NAP activities formulation.
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Myanmar, as a country going through rapid socio-political transition and institutional development also suffers with a high burden of infectious disease. An ongoing challenge has been to effectively reach its 51 million population, most of whom battle tuberculosis, acute respiratory infections, diar...rhoea and malaria including amongst under-five children.
Limited research data on the occurrence of resistant organisms in the nation have, makes it hard to estimate the exact antimicrobial resistance (AMR) scenario. Limited peer reviewed evidence indicates significant divergence from the average resistance trends in APAC region. Nevertheless, several key steps by Government of Myanmar have been instrumental in paving the way for the country to join other nations in the South East Asia Region to speed up its plan on addressing the AMR crisis. Combating antimicrobial resistance would, however, require highest political commitment, multi-sectoral coordination, sustained investment and technical assistance.
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Although Shiga toxin-producing Escherichia coli (STEC) have been isolated from a variety of food production animals, they are most commonly associated with ruminants from which we derive meat and milk. Because of the widespread and diverse nature of ruminant-derived food production, coupled with the... near ubiquity of STEC worldwide, there is no single definitive solution for controlling STEC that will work alone or in all situations. Instead, the introduction of multiple interventions applied in sequence, as a “multiple-hurdle scheme” at several points throughout the food chain (including processing, transport and handling) will be most effective.
This report summarizes the review and evaluation of interventions applied for the control of STEC in cattle, raw beef and raw milk and raw milk cheese manufactured from cows’ milk, and also evaluates available evidence for other small ruminants, swine and other animals. The information is presented from primary production, to the end of processing, providing the reader with information on the currently available interventions based on the latest scientific evidence.
This work was undertaken to support the development of guidelines for the control of STEC in beef, raw milk and cheese produced from raw milk by the Codex Committee on Food Hygiene (CCFH).
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