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2
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This global status report on prevention and control of NCDs (2014), is framed around the nine voluntary global targets. The report provides data on the current situation, identifying bottlenecks as well as opportunities and priority actions for attaining the targets. The 2010 baseline estimates on N
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CD mortality and risk factors are provided so that countries can report on progress, starting in 2015. In addition, the report also provides the latest available estimates on NCD mortality (2012) and risk factors, 2010-2012.All ministries of health need to set national NCD targets and lead the development and implementation of policies and interventions to attain them. There is no single pathway to attain NCD targets that fits all countries, as they are at different points in their progress in the prevention and control of NCDs and at different levels of socioeconomic development. However all countries can benefit from the comprehensive response to attaining the voluntary global targets presented in this report.
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In 2018 the Astana Declaration reaffirmed a global commitment to PHC as a cornerstone of sustainable health systems for accelerated progress on universal health coverage (UHC) (1). The vision for PHC in the 21st century is for a wholeof-government and whole-of-society approach to health that combine
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s: 1) multisectoral policy and action; 2) empowered people and communities; and 3) primary care and essential public health functions as the core of integrated health service. Signatories, including Nigeria, were urged to implement the vision and commitments of the Declaration according to their national contexts. This case study examines Nigeria’s response to COVID-19 from a PHC perspective between March 2020 and mid-2021.
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Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worldwide, particularly for low-middle income countries where the problem seems to be worsening. Globally,
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research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control. Meanwhile the premature mortality caused by NCDs remains high in many countries. In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formu- lating national plans to combat NCDs.
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Health system resilience is not an inevitable byproduct of any investment in health but must be intentionally programmed and developed with necessary input, investment and contextualization. This technical product aims to guide national, subnational, and global health actors to operationalize the co
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ncept of health system resilience for advancement of universal health coverage, health security and ultimately better health for all. It supports the translation of relevant conceptual guidance and high-level recommendations into practical actions.
The specific objectives are to:
present a concise overview of the concept of health system resilience;
provide a roadmap outlining practical and foundational steps for building health system resilience to be adapted to different contexts;
share examples of actions and tools, including stakeholder roles, to support country application of the roadmap.
The target audience for this work is the various stakeholders involved in strengthening health systems and public health including management of emergencies (from prevention and preparedness to response and recovery) and other public health challenges in countries. This ranges from the donors, policy-makers and decision-makers at global, national and subnational levels to the implementing institutions and line managers of health system functions and services across the health system building blocks.
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The Department of Noncommunicable Diseases and Mental Health (NMH) is responsible for promoting, coordinating, and implementing technical cooperation activities related to the prevention, control, and surveillance of noncommunicable diseases, all forms of malnutrition, mental health, neurological an
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d substance use disorders, including their risk factors. It also promotes policies and strategies related with disabilities and rehabilitation, road safety, as well as prevention of and response to violence in all its forms.
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Lung health in Africa: challenges and opportunities in the context of COVID-19
Ozho, O.B.; Mbatchou Ngahane, B.H.; Zar, H.J.; et al.
American Journal of Physiology - Lung Cellular and Molecular Physiology
(2021)
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The article discusses the challenges and opportunities for lung health in Africa in the context of the COVID-19 pandemic. It highlights the strain on healthcare systems, the increase in chronic respiratory diseases like asthma and COPD, and the limited resources for managing these conditions. The pa
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ndemic has exacerbated issues like delayed diagnosis and treatment, while also impacting child lung health and increasing risks for those with tuberculosis. It emphasizes the importance of leveraging global partnerships and strategies to improve healthcare infrastructure and response in Africa.
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Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensu
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s diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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Language influences the way we think, how we perceive reality, and how we behave. With respect to HIV, language can embody stigma and discrimination, which impacts access to testing, acquisition of HIV, and engagement with treatment. Language plays a role in supporting respect and empowerment of ind
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ividuals, as communities shape how they are referred to and the labels they wish to use. Consideration and use of appropriate language can strengthen the global response to the HIV pandemic by diminishing stigma and discrimination and increasing support and understanding for individuals and communities living with HIV. Comments and suggestions for modifications should be sent to
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On 13 August 2024, Africa Centres for Disease Control and Prevention (Africa CDC) declared the ongoing Mpox outbreak a Public Health Emergency of Continental Security (PHECS). This was followed the next day by the World Health Organization (WHO), which extended the alert internationally as a public
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health emergency of international concern (PHEIC). After these declarations, many countries have made efforts to mobilize resources to introduce or expand laboratory testing, surveillance, and response activities. In particular, as the number of suspected cases surges in the Democratic Republic of Congo (DRC), Burundi, and the Central African Republic, and an increasing number of new countries report cases, there is an urgent need to implement testing to strengthen the Mpox response. However, access to appropriate quality assured diagnostics is a challenge. There is limited information on important characteristics, such as available test kits’ performance and ability to detect relevant clades.
To address the challenge of mpox access in the continent, the Africa CDC Diagnostic Advisory Committee (DAC) met in Kigali from 19-23 August 2024 to review the available evidence on molecular tests for Mpox and to shortlist tests that may be useful for Mpox testing in countries. The shortlist aims to provide guidance to Africa CDC, countries and partners on appropriate high-quality molecular tests to procure and use for the mpox response.
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The Implementation toolkit for accessible telehealth services provides practical guidance to support governments, industry partners, health service providers and civil society groups in the use and implementation of the WHO-ITU Global standard for accessibility of telehealth services. The toolkit is
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the result of a collaboration between the World Health Organization and the International Telecommunication Union, and was developed in response to the growing challenges that persons with disabilities and other marginalized populations experience when accessing and using telehealth platforms around the world.
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Uganda is Africa's largest refugee-hosting country and ranks fifth globally. Over the decades, Uganda has hosted refugees from nations including South Sudan, the Democratic Republic of Congo, Eritrea, Somalia, Sudan, Burundi, and Rwanda. As of early 2024, it hosts 1 600 000 refugees, primarily in re
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fugee settlements in northern and southwestern Uganda, and in Kampala City. Thirteen districts accommodate 94% of these refugees.
The World Health Organization (WHO) and Uganda’s Ministry of Health conducted a joint review mission to provide a comprehensive overview of the health system's response. The aim was to understand service delivery challenges and identify opportunities to further support Uganda in strengthening health system capacity and ensuring continued access to health services for refugees, migrants and host communities.
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The postpartum period is a critical time for mothers and newborns, who require essential hygiene and personal items, such as menstrual pads, clothes, and diapers, to ensure their well- being and health. Although these items are simple, they can significantly enhance well- being. Conversely, lacking
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these essentials can increase the risk of infections for mothers and newborns.
In Gaza, the current emergency situation has meant women face significant limitations in accessing these essential items due to market unavailability, financial constraints, high security risks, and border closures.
In response, organizations working in sexual and reproductive health in Gaza have united to provide postpartum kits (PPKs) to mothers and newborns effectively.
With approximately 4,000 live births occurring in Gaza each month, it is crucial for partners to collaborate in advocating for resources and ensuring timely procurement and distribution of these kits.
Moreover, to ensure equitable access and consistent quality of the kits for all women, partners have agreed on a unified set of criteria for their composition and distribution.
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Based on an increasing body of evidence pointing at the positive impact that social assistance has had in Malawi, the region and beyond, government is encouraged to continue investing in and supporting the expansion and comprehensiveness of social protection programmes in both rural and urban areas,
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ensuring they effectively target and adequately address needs and vulnerabilities across the lifecycle, in line with the Malawi National Social Support Programme (MNSSP II) and Vision 2063. In addition, Government and Development Partners are encouraged to further the integration between social protection, the humanitarian and the disaster risk management sectors in response to shocks and stresses, through the roll out of a fully shock-sensitive social protection system.
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The World Health Organization provides regional and national strategies and operational plans that aim to support countries in work to achieve measles control and elimination. These are guided by high level frameworks including the Immunization Agenda 2030 and the Measles and Rubella Strategic Frame
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work 2021–2030. These frameworks promote improvements in routine immunization programmes to reach all children, reduce immunity gaps and prevent outbreaks within the context of universal health care.
This interim guidance on Targeted and selective strategies in measles and rubella vaccination campaigns adds to the suite of guidance documents. It provides expanded description of methods to determine age groups for inclusion in preventive and outbreak response measles and rubella vaccination campaigns; and operational considerations that are specific to targeted and selective strategies in measles and rubella vaccination campaigns. This guidance also updates definitions for tailored, targeted and selective campaigns.The World Health Organization provides regional and national strategies and operational plans that aim to support countries in work to achieve measles control and elimination. These are guided by high level frameworks including the Immunization Agenda 2030 and the Measles and Rubella Strategic Framework 2021–2030. These frameworks promote improvements in routine immunization programmes to reach all children, reduce immunity gaps and prevent outbreaks within the context of universal health care.
This interim guidance on Targeted and selective strategies in measles and rubella vaccination campaigns adds to the suite of guidance documents. It provides expanded description of methods to determine age groups for inclusion in preventive and outbreak response measles and rubella vaccination campaigns; and operational considerations that are specific to targeted and selective strategies in measles and rubella vaccination campaigns. This guidance also updates definitions for tailored, targeted and selective campaigns.
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Situation analysis
Description of the disaster
An Ebola epidemic that started in March 2014 in Guinea has relentlessly continued to claim lives and to spread to other countries in West Africa. The current Ebola outbreak is the largest in history and the first to affect multiple countries simu
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ltaneously. There have been over 24 000 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia and Sierra Leone (table 1), with almost 10 000 reported deaths (outcomes for many cases are unknown). A total of 58 new confirmed cases were reported in Guinea, 0 in Liberia, and 58 in Sierra Leone in the 7 days to 8 March (4 days to 5 March for Liberia). Many experts believe that the official numbers substantially understate the size of the outbreak because of families' widespread reluctance to report cases. Because of the fluidity of movement of people between West Africa and several countries in the East African countries, especially Kenya and Ethiopia (who in turn have extensive interaction with other countries in the region in terms of human movement), the risk of an outbreak of Ebola in East Africa is as eminent as in any of the countries bordering the affected countries. The IFRC regional office intends to support National Societies to raise their Ebola preparedness and response capacity through training, technical support in planning and implementation of Ebola related activities, and coordination both within and outside the movement.
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AVADAR is a mobile sms-based software application designed to improve the quality and sensitivity of Acute Flaccid Paralysis (AFP) surveillance by health workers and key informants within hospital facilities and local communities.
The idea is simple: Health workers visit remote villages to check if
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local inhabitants have any symptoms of a range of life-threatening infectious diseases, including polio and measles. Then, with the mobile app, they quickly and easily alert WHO.
The AFP video component was developed by World Health Organization (WHO) and eHA, and the software design component was handled by Novel-T. To date, eHA has translated the app into 17 languages.
Informant Selection & Capacity Building
The selection of informants (including health workers) was led by the WHO and each country’s Ministry of Health team. Once selected, screening and training was jointly conducted by WHO, the Ministries of Health, and eHealth Africa team.
In several countries, “special informants” with limited literacy participate in the project via a simplified version of the app that only requires a “yes” or “no” response to having seen a child with AFP symptoms
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Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t
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echnologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden
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ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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History has shown that governments tend to deprioritize environmental commitments during times of financial and public crises as they work to mitigate immediate needs—and the age of COVID-19 has been no different. Even though human interaction with wildlife is believed to be the cause of the pande
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mic, the focus on COVID’s fallout has deprioritized the importance of reversing the damage humans have done to the planet.
COVID has had a multifaceted and detrimental effect on environmental conservation. Not only has funding been diverted to deal with the pandemic, conservation-oriented organizations are operating with minimal staff or have closed entirely. People whose daily work it is to advance environmental science and protect the land and water have become ill or have been forced to stay home because of travel restrictions. Plastic use is at an all-time high.
The good news is that there is an unprecedented opportunity for philanthropy to recharge the effort to protect the planet. This Giving Smarter Guide examines the state of environmental philanthropy, and provides an overview of potential strategic starting points for philanthropy and impact capital to play a role in saving the planet. In addition to offering recommendations specific to the COVID-19 response, the Center for Strategic Philanthropy also asks the questions that philanthropists should consider at the start of their journey into the field of conservation philanthropy.
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Climate change presents the single biggest threat to human development, and its widespread impacts disproportionately burden the poorest and most vulnerable households in fragile and rural developing contexts – particularly women and children.
According to the Intergovernmental Panel on Climate C
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hange’s (IPCC) latest report, ‘between 2010 and 2020, droughts, floods and storms killed 15 times as many people in highly vulnerable countries, particularly in Africa — which is responsible for less than 3 percent of global emissions – than in the wealthiest countries’.
Recognising environmental degradation and climate change are key accelerators of extreme child vulnerability, World Vision (WV) approved the Environmental Stewardship Management Policy (‘the Policy’) and Guidelines (‘the Guidelines’) in 2021.
To support the implementation of the Policy and Guidelines, WV has developed this Environmental Stewardship and Climate Action Handbook (‘the Handbook’) to help offices across the WV Partnership implement best practice environmental management strategies both in the field and in our operations and facilities.
Integrating environmental stewardship and climate action into all our work – whether that be in our Area Programmes, grant projects, responses to disasters or advocacy – is critical to achieving WV’s strategy.
As a Christian organisation we are compelled to follow the ways of Jesus Christ, calling us to care for the ‘least of these’ (Matthew 25:40) – the vulnerable children who are disproportionately impacted by climate change. Our response to the degradation of the environment is not motivated by political expediency or funding – but because we are called to steward God’s creation (Genesis 1:28).
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