PNAS 119 (8) e2113947119 | https://doi.org/10.1073/pnas.2113947119
Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, m...easure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment and care and mental health services for people living with HIV. It provides a compilation of tools, best practices, recommendations and guidelines that facilitate the integration of i...nterventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
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In 2007, the Sixtieth World Health Assembly adopted resolution WHA60.13 on control of leishmaniasis, urging Member States, among other actions:
to strengthen prevention, active detection and treatment of cases of both cutaneous and visceral leishmaniasis in order to decrease the disease burde...n; and
to strengthen the capacity of peripheral health centres to deliver primary and secondary care, so that they provide appropriate affordable diagnosis and treatment and act as sentinel surveillance sites.
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We need to be concerned about mental health in the context of climate change
The practice of female genital mutilation (FGM) has proved remarkably tenacious, despite attempts spanning nearly a century to eliminate it. Nevertheless, a number of countries have seen some declines in the practice – at least up until the COVID-19 pandemic, the impact of which is yet to be fully... understood. Other changes in FGM are also evident. These include shifts in attitudes and in the ways the procedure is being carried out.
As the world rallies to accelerate progress against FGM, understanding what drives change in how people think about the practice and act is key to its elimination. Education is one such driver. It is an important mechanism to increase awareness of the dangers of FGM and of groups that do not practise it. Education also fosters questioning and discussion and provides opportunities for individuals to take on social roles that are not dependent on the practice of FGM for acceptance.
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Cases of human monkeypox are rarely seen outside of west and central Africa. There are few data regarding viral kinetics or the duration of viral shedding and no licensed treatments. Two oral drugs, brincidofovir and tecovirimat, have been approved for treatment of smallpox and have demonstrated eff...icacy against monkeypox in animals. Our aim was to describe the longitudinal clinical course of monkeypox in a high-income setting, coupled with viral dynamics, and any adverse events related to novel antiviral therapies.
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As the world recovers from the shock of the COVID-19 pandemic and reflects on lessons learnt from failure of global public health systems to contain the global outbreak of SARS-CoV-2, new infectious disease threats, caused by movement of people globally, remain omnipresent, and repeated calls for mo...re proactive action go unheeded. This is aptly shown by the unprecedented and unexpected outbreaks of human monkeypox cases and clusters since May 7, 2022, across Europe, the Americas, and Australia,
which yet again, have taken global public authorities by surprise.
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Preventing tuberculosis infection from progressing to tuberculosis disease is a crucial component of the goal to eliminate tuberculosis. When deciding on the use of tuberculosis preventive therapy among household contacts, policy makers regularly ask questions, such as whether tuberculosis preventiv...e therapy is effective, safe, and feasible in a programme setting and what it will cost. For contact management and tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis, studies from high-income and low-income countries have shown feasibility, safety, and effectiveness.
However, there is scarce information on the cost of tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis. In The Lancet Global Health, Peter Dodd and colleagues show that household contact management strategies are cost-effective even in low-income and middle-income countries, which has important policy implications for achieving the END TB Strategy goals.
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The Lancet Planetary Health Volume 6, ISSUE 5, e388-e390, May 01, 2022. As the Stockholm Declaration on the Human Environment turns 50, the role of the health stakeholder community in forward-looking environmental agendas is more important than ever. Breathing air, drinking water, and eating food i...s a daily requirement for healthy human bodies. These basic needs inextricably link human health to the health of our environment. Hence, core elements of the global environmental movement were built on concern for the negative impact of pollution on human and ecosystem health.
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Human rights-based approaches to the creation of knowledge involve application of human rights principles to both the content and process of knowledge creation. Human rights-based approaches have special significance for the sexual and reproductive health and rights (SRHR) of all people, in particul...ar for women and girls, people living with disability, lesbian, gay, bisexual, trans, queer or Intersex (LGBTQI) populations, refugees, migrants and other marginalised populations.
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This routine assessment supports the targeting and provision of humanitarian assistance to the affected population and serves as a preliminary source to identify oblasts and hromadas hosting high numbers of IDPs.
Virtually all (99.9 percent) of Southeast Asia’s 656.1 million people live in areas where particulate pollution exceeds the World Health Organization (WHO) guideline of 5 μg/m³. Despite the lockdowns of the pandemic, pollution continued to rise in much of Southeast Asia in 2020. This pollution c...uts short the life expectancy of the average Southeast Asian person by 1.5 years, relative to what it would be if the WHO guideline was met. That’s a total of 959.8 million person-years lost to pollution in the eleven countries that make up this region. Some countries in the region experience greater impacts from pollution.
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Bangladesh is the world’s most polluted country. Air pollution shortens the average Bangladeshi’s life expectancy by 6.9 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m³ was met. Some areas of Bangladesh fare much worse than average, with air poll...ution shortening lives by nearly 9 years in Dhaka, the country’s most polluted city.
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Pakistan is the world’s fourth most polluted country. Air pollution shortens the average Pakistani’s life expectancy by 3.8 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m3 was met.1 Some areas of Pakistan fare much worse than average, with air pol...lution shortening lives by almost 7 years in the country’s most polluted regions, like Lahore and Peshawar.
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Nepal is the world’s third most polluted country. Air pollution shortens average Nepalese life expectancy by 4.1 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m3 was met.1 The highest concentrations of air pollution are observed in Nepal’s southwes...tern districts, which share their borders with the highly-polluted Indo-Gangetic Plain of India. Here, residents stand to lose nearly 7 years of life expectancy.
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Air pollution’s impact on life expectancy in Nigeria is greater than that of HIV/AIDS and almost on par with malaria and unsafe water and sanitation, shortening the average Nigerian’s life expectancy by 1.8 years, relative to what it would be if the World Health Organization (WHO) guideline of 5... μg/m3 was met.1 Some areas of Nigeria fare much worse than average, with air pollution shortening lives by almost 4 years on average in parts of Taraba state in Northeastern Nigeria.
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