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Therapeutics and COVID-19 (Living Guideline, 10 November 2023)

World Health Organization WHO (2023) C_WHO

WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines. Updated risk rates for hospital admission in patients with non-severe COVID-19 The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19. The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients. This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines: **High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%. **Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%. Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk. Review of COVID-19 treatments for people with non-severe COVID-19 WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022. If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead. WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission. For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol. WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials. The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials. more

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Screening for cardiovascular disease risk and subsequent management in low and middle income countries: challenges and opportunities

Bovet, P.; Chiolero, A.; Paccaud, F. et al. Public Health Reviews (2015) CC

Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the leading cause of premature mortality in low and middle income countries (LMICs). Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector... more

WHO package of essential noncommunicable (PEN) disease interventions for primary health care

World Health Organization (WHO) World Health Organization (WHO) (2020) C_WHO

The "WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care" provides a set of cost-effective, evidence-based interventions to address noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers. Designed ... more

Task-shifting to improve asthma education for Malawian children: a qualitative analysis

Nkhalamba, L.; Rylance, S.; Muula, S. A. et al. Human Resources for Health (2021) CC

Background Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a... more

HEARTS en las Américas: Compendio de herramientas clínicas esenciales 2023

Pan American Health Organisation PAHO (2024) CC

Desde el 2016, la Organización Panamericana de la Salud (OPS) ha promovido la implementación de la Iniciativa HEARTS en las Américas, una adaptación regional de la estrategia Global HEARTS de la Organización Mundial de la Salud (OMS). Durante este tiempo, 33 países de la Región de las Améric... more

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Cardiovascular, Respiratory, and Related Disorders. Disease Control Priorities, Third Edition : Volume 5

rabhakaran, Dorairaj; Anand, Shuchi; Gaziano, Thomas A.; et al. World Health Organisation (WHO) (2017) CC

This volume on CVDs, renal, and respiratory disorders has particularly high value. It carries the potential to become the most effective game-changer in global health by helping all countries to combat, contain, and control the biggest killer presently prowling the globe and by enabling us to reach ... more

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Agenda for the Americas on Health, Environment, and Climate Change 2021–2030

Pan American Health Organization (2021) C_WHO

This publication presents the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda). The Agenda is a call to action to the health sector to lead the charge to address environmental determinants of health in the Americas. The Pan American Health Organization (PAH...O) 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 has been 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. The Agenda was developed in consultation with the Technical Advisory Group and through a consensus-driven decision-making process with Member States during the 2019–2020 period. Looking toward the achievement of Sustainable Development Goal 3, the Agenda focuses on: improving the performance of environmental public health programs and institutions; fostering environmentally resilient and sustainable health systems; and promoting environmentally healthy and resilient cities and communities. Its implementation will be context-specific, based on the needs and realities of the countries. It will benefit countries and territories by promoting good governance practices, strengthening the leadership and coordination roles of the health sector, fostering cross-sectoral action, focusing on primary prevention, and enhancing evidence and communication. It will facilitate access to human, technical, and financial resources necessary to address environmental determinants of health and ensure that the Region is fully engaged in global health, environment, and climate change processes and agreements. The objective of the Agenda is to strengthen the capacity of health actors in the health and non-health sectors to address and adapt to environmental determinants of health (EDHs), prioritizing populations living in conditions of vulnerability, in order to meet Outcome 18 of the PAHO Strategic Plan 2020–2025 directly and several other outcomes of the Plan indirectly. To address and adapt to the challenges of EDHs in the Region, an integrated and evidence-informed approach within the health sector and across sectors will be needed, one enabled, and supported by good governance practices, adequate management mechanisms, high-level political will, and adequate human, technical, technological, and financial resources. more

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A Roadmap to combat postpartum haemorrhage between 2023 and 2030

World Health Organization WHO (2023) C_WHO

WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths. Despite being preventable and treatable, PPH results in around 70 000 de... more

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Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja, N.W.; Nakagaayi, D.; Aliku, T. et al. Frontiers in Cardiovascular Medicine (2022) CC

In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide. There is currently an epide...miological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality. more

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Guidelines for drinking-water quality: Small water supplies

World Health Organization WHO (2024) C_WHO

Small drinking-water supplies commonly experience operational, managerial, technical and resourcing challenges that impact their ability to deliver safe and reliable services. The needs and opportunities associated with these supplies therefore warrant explicit consideration in policies and regulati... more

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Guidance to facilitate monitoring and evaluation for antimicrobial resistance national action plans

Quadripartite: Food and Agriculture Organization of the United Nations FAO; UN Environment Programme UNEP; World Health Organization WHO; World Organisation for Animal Health WAHO (2023) CC

Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security and safety, environmental effects on ecosystems and biodiversity, and ...socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”. The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines. Its strategic objectives include: • improving the awareness and understanding of AMR; • strengthening the knowledge and evidence base through surveillance and research; • reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and • developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions. With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives more

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Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

Yuyun, M.F.; Sliwa, K.; Kengne, A.P. et al. Global Heart (2020) CC

Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t... more

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Community-Based Mental Health: A Training Guide for Community Providers

International Federation of Red Cross and Red Crescent Societies IFRC (2023) CC

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... more

The Burden of Pediatric Asthma

Ferrante, G.; La Grutta, S. Frontiers in Pediatrics (2018) CC

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... more

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European Respiratory Society clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years

Gaillard, E.A.; Kuehni, C.E.; Turner, S.; et al. European Respiratory Journal (2021) CC

Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence... more

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Safety and monitoring in patients receiving remdesivir for COVID-19
recommended

World Health Organization WHO (2022) C_WHO

This series of supportive tools are based on the WHO Therapeutics and COVID-19: living guideline. They are intended to provide supportive information for healthcare workers who are prescribing, administering and monitoring patients receiving nirmatrelvir-ritonavir for non-severe COVID-19.

Pioneer Project: A holistic systems strengthening approach towards Malaria control in Mid-Western Uganda

Malaria Consortium and Comic Relief (2014) C1

Successes and lessons

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Sensitizing health workers to providing responsive care for adolescents and young people living with HIV

H. Soeters; D. Mark; A. Ronan; et al. World Health Organization; Unicef; Pata (2019) C_WHO

Accessed: 08.10.2019

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Chain-free initiative

World Health Organization WHO (2019) CC

The chain-free initiative evolved in response to an urgent need to: provide technical and financial support for hospital reform, improve domestic conditions for people with mental illness, develop community care programmes, raise mental health literacy in the community and among health workers, and ... more

Guidelines on compounding of medicines

Pharmacy Board of Australia (2018) C1

Safety and monitoring in patients receiving remdesivir for COVID-19 recommended

Safety and monitoring in patients receiving remdesivir for COVID-19
recommended