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Reports of antimicrobial-resistant (AMR) microorganisms are increasing globally, threatening to render existing treatments ineffective against many infectious diseases. In Africa, AMR has already been documented to be a problem for human immunodeficiency virus (HIV) and the pathogens that cause
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malaria, tuberculosis (TB), typhoid, cholera, meningitis, gonorrhoea and dysentery. Recognizing the urgent need for action, the 2016 United Nations (UN) General Assembly approved a resolution to ensure sustained and effective global action to address AMR.
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sur la base des orientations actuelles de l’OMS, 31 may 2021. Aide mémoire
This aide-mémoire presents information on use and procurement of masks for community outreach interventions, with a focus on those for malaria, neglected tropical diseas
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es, tuberculosis, HIV/AIDS and vaccine-preventable diseases. It details requirements for the different types of professionals involved (e.g. health workers, social mobilizers, data collectors, logisticians, insecticide spraying personnel, etc.), based on their level of risk of potential exposure to SARS-CoV-2.
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Clinical Microbiology and Infection Volume 21, Issue 5, May 2015, Pages 433-443;
The neglected zoonotic diseases (NZDs) have been all but eradicated in wealthier countries, but remain major causes of ill-health and mortality across Africa, Asia, and Latin America. This neglect is, in part, a conse
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quence of under-reporting, resulting in an underestimation of their global burden that downgrades their relevance to policy-makers and funding agencies. Increasing awareness about the causes of NZDs and how they can be prevented could reduce the incidence of many endemic zoonoses.
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Biodiversity and healthy natural ecosystems, including protected areas in and around cities, provide ecosystem benefits and services that support human health, including reducing flood risk, filtering air pollutants, and providing a reliable supply of clean drinking water. These services help to red
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uce the incidence of infectious diseases and respiratory disorders, and assist with adaptation to climate change. Access to nature offers many other direct health benefits, including opportunities for physical activity, reduction of developmental disorders and improved mental health.
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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
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in these communities, it is necessary to respond to 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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Chagas disease is currently endemic and also predicted to be at increased transmission risk under future climate change scenarios. Similarly, an expansion of areas in the United States at increased risk for Chagas disease transmission is also expected over the next several decades under climate chan
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ge scenarios. Of particular interest is the predicted northern shift of triatomine species to central regions of the United States with historically unsuitable climates for T. cruzi vectors. The weight of evidence regarding the influences climate change may pose on T. cruzi vector species distributions demonstrates the sensitivity of Chagas disease transmission to future climate variability. In order to advance forecasts for the impact climate change may have on Chagas disease transmission in the Americas, it is imperative to
further develop, utilize, and perhaps combine predictive species distribution modeling approaches that integrate accurate, long term data on climate variables, vector species distributions, Chagas disease incidence, as well as other socio-ecological variables.
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While there has been real progress in addressing the burden of disease in the WHO African region, the COVID-19 pandemic has highlighted the link between health, economics and security, as the region saw decades of progress threatened, including positive trends in decreasing inequality. In the Africa
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n Region the momentum towards achieving the 2030 SDG disease burden reduction targets (SDG targets 3.3, 3.4 and 3B) has stalled.
The COVID-19 pandemic was also a major threat to gains made, such as the eradication of polio in the region, declared in 2020; reduced numbers of new HIV infections in 2021 compared to 2010; and passing the 2020 milestone of the End TB Strategy, with a 22% reduction in new cases compared with 2015. However, the pandemic also disrupted essential health services in 92% of countries globally, 22.7 million children missed basic immunization, there was an increase in malaria and TB, and global deaths from TB rose for the first time since 2015.
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Antimicrobial resistance (AMR) has emerged as a leading cause of death in the African region, surpassing fatalities from malaria, HIV, and TB. In response to this critical threat, the region has adopted the AMR Global Action Plan and the African Uni
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on Framework for Antimicrobial Resistance Control 2020 – 2025, which is tailored to meet the specific needs of African nations through a coordinated approach. While most countries in the region have developed and prioritized National Action Plans (NAPs) to tackle AMR, the overall response remains inadequate given the magnitude of the threat, which endangers human, animal, environmental, aquatic, and plant health.
Africa bears a significant burden of infectious diseases, accounting for approximately 95% of malaria deaths, 70% of people living with HIV, and 25% of TB deaths globally. In 2019, AMR was linked to approximately 55,000 deaths from HIV, 30,000 from malaria, and 255,000 overall. Major drivers of AMR in the region include the overuse and misuse of antimicrobials in human and food systems, migration, suboptimal vaccination rates, and environmental contamination from hospital and pharmaceutical effluents. Additionally, there is a lack of access to quality-assured antimicrobials and diagnostics, compounded by inadequate knowledge about AMR. Unlike high-income countries, where indiscriminate antimicrobial use is the primary factor driving AMR, African countries face additional challenges, including a lack of access to clean and safe water, poor Water, Sanitation, and Hygiene (WASH) programs, inadequate infection prevention measures, and suboptimal vaccinations for preventable diseases. One in three hospitals in the region lacks clean, safe running water, and one in eight people defecate openly due to inadequate sanitation. Investments in WASH, infection prevention, and biosecurity could save approximately 700,000 lives annually.
Addressing AMR in Africa requires a comprehensive, multi-sectoral approach involving the entire society. Sustainable access to antimicrobials, including antibiotics, vaccines, and therapeutics, is crucial, as lack of access leads to more morbidity and mortality than AMR itself. Support for the region should focus on preventing infections, strengthening health and food systems, developing human resources, ensuring sustainable access to diagnostics and therapeutics, and investing in laboratory infrastructure to support surveillance and data generation.
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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
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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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This World Health Organization (WHO) and the International Labour Organization (ILO) joint guidelines production aims at harnessing the contribution of employers and workers towards the control of TB. It covers all the practical steps involved in establishing TB control activities, including (for la
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rge employers) starting and running a workplace TB control programme. They are intended for use in all countries in which TB incidence is high and the target audience for the guidelines includes employers, employee organizations, NTP managers, and agencies providing technical support for TB control.
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The main aim of these guidelines is to enable the central units of national TB and HIV/AIDS programmes to support districts to plan, coordinate and implement collaborative TB/HIV activities. These guidelines reinforce current medical understanding, that highly active antiretroviral treatment (HAART)
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has decreased TB incidence of people living with HIV/AIDS. They are comprehensive, giving an overview of the range of activities that could be undertaken in high burden TB/HIV countries or where a rising prevalence of HIV might fuel TB. Activities highlight the need for comprehensive care, prevention and support for adults living with HIV/AIDS. Comprehensive TB and HIV care and prevention rely on full implementation of the DOTS strategy as part of a wide ranging HIV/AIDS care and prevention programme as well as collaborative TB and HIV programme activities.
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The main objective of the 2014-15 RDHS was to obtain current information on demographic and health indicators, including family planning; maternal mortality; infant and child mortality; nutrition status of mothers and children; prenatal care, delivery, and postnatal care; childhood diseases; and ped
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iatric immunization. In addition, the survey was designed to measure indicators such as domestic violence, the prevalence of anemia and malaria among women and children, and the prevalence of HIV infection in Rwanda. For the first time, this 2014-15 RDHS also includes indicators to monitor HIV testing among children age 0-14 as well as domestic violence for males age 15-59.
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National Strategic Plan for Newborn and Child Health Development (2015-2018)
The Republic of the Union of Myanmar, Ministry of Health, Department of Health, Child Health Division
World Health Organization (WHO), Country Office for Myanmar
(2015)
C_WHO
No publication year indicated
The specific objectives of the plan are to:
- Scale up evidence-based, cost effective interventions through effective strategies within a HSS approach and provide equitable coverage with quality.
- Reduce neonatal mortality by improved home-based newborn ... care, early identification of sick newborns and improved access to institutional newborn care of adequate quality.
- Reduce common childhood illness related mortality (due to pneumonia and diarrhoea in all areas and malaria in endemic areas) by improving key family and community practices, community-based early diagnosis and management and referral care for complicated cases. more
The specific objectives of the plan are to:
- Scale up evidence-based, cost effective interventions through effective strategies within a HSS approach and provide equitable coverage with quality.
- Reduce neonatal mortality by improved home-based newborn ... care, early identification of sick newborns and improved access to institutional newborn care of adequate quality.
- Reduce common childhood illness related mortality (due to pneumonia and diarrhoea in all areas and malaria in endemic areas) by improving key family and community practices, community-based early diagnosis and management and referral care for complicated cases. more
The impact of transition from global fund support to governmental funding on the sustainability of harm reduction programs
S. Ibisevic; G. Shaw; Dr. S. Godinjak; Dr. Z. Cardaklija; et al.
Eurasian Harm Reduction Network; ICASO
(2016)
C2
A case study from Bosnia and Herzegovina Eurasian Harm Reduction Network
The case study was prepared by Samir Ibisevic, President of PROI between March and June 2016 and edited by Graham Shaw.
EHRN is grateful to all who contributed to this document, especially: Dr. Serifa Godinjak, Chairperson
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of Country Coordinating Mechanism; Dr. Zlatko Cardaklija, HIV Coordinator for the Federation of Bosnia and Herzegovina (BiH); Dr. Nesad Seremet, Head of the HIV program, United Nations Development Program in Bosnia and Herzegovina; Ms. Gyongyver Jakab, Fund Portfolio Manager, Eastern Europe and Central Asia and Ms. Natalya Bogach, Program Officer, The Global Fund to Fight AIDS, Tuberculosis and Malaria; Dr. Nermana Mehic–Basara, Director of the Institute for Addiction Diseases of Sarajevo Canton; Mr. Denis Dedajic, Director of the Association Margina from the Federation of BiH; Mr. Srdjan Kukolj, Director of Action Against AIDS from the Republic of Srpska.
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A case study from Albania
June 2016
EHRN is grateful to all who contributed to this document, especially (in alphabetical order): Alena Alba, Program Officer, Eastern Europe and Central Asia Team, Asia, Europe, Latin America and the Caribbean Department, The Global Fund to Fight AIDS, Tuberc
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ulosis and Malaria, Geneva; Roland Bani, Head, National AIDS Program, Institute of Public Health, Ministry of Health, Tirana; Gazmend Bejtja, Director, Health Care Directory, Ministry of Health, Tirana; Arian Boci, Director, Stop AIDS, Tirana; Bujana Hoti, UNAIDS Focal Point, Tirana; Gyöngyvér Jakab, Fund Portfolio Manager, Eastern Europe and Central Asia, Asia, Europe, Latin America and the Caribbean Department, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva; Manjola Kola, CCM Secretariat, Tirana; Sokol Morina, Coordinator, Control of illicit Drugs and Alcohol Addiction, Ministry of Health, Tirana; Genci Muçollari, Director, Aksion Plus, Tirana; and Dorina Tocaj, National Program Officer, UNFPA, Tirana.
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In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike. People did not know where to
go for their health care. Salaries were not paid for more than
six months and life for the general population wa
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s very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
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Large-Scale UN Response Needed to Address Health and Food Crises
This report is based on interviews with more than 150 health care professionals, Venezuelans seeking or in need of medical care who recently arrived in Colombia and Brazil, representatives from international and nongovernmental humani
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tarian organizations. In addition, researchers analyzed data on the situation inside Venezuela from official sources, hospitals, international and national organizations, and civil society organizations.
We found a health system in utter collapse with increased levels of maternal and infant mortality; the spread of vaccine-preventable diseases, such as measles and diphtheria; and increases in numbers of infectious diseases such as malaria and tuberculosis (TB). Although the government stopped publishing official data on nutrition in 2007, research by Venezuelan organizations and universities documents high levels of food insecurity and child malnutrition, and available data shows high hospital admissions of malnourished children.
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In Kenya, the bacterial infections that contribute most to human disease are often those in which re-‐sistance is most evident. Examples are multidrug-‐resistant enteric bacterial pathogens such as typhoid,
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diarrhoeagenic Escherichia coli and invasive non-‐typhi salmonella, penicillin-‐resistant Streptococcus pneu-‐moniae, vancomycin-‐resistant enterococci, methicillin-‐resistant Staphylococcus aureus and multidrug-‐re-‐sistant Mycobacterium tuberculosis. Resistance to medicines commonly used to treat malaria is of particu-‐lar concern, as is the emerging resistance to anti-‐HIV drugs. Often, more expensive medicines are required to treat these infections, and this becomes a major challenge in resource-‐poor settings.
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It estimates that there have been 228,000 additional deaths of children under five in these six countries [Afghanistan, Nepal, Bangladesh, India, Pakistan and Sri Lanka] due to crucial services, ranging from nutrition benefits to immunisation, being halted.
It says the number of children being tr
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eated for severe malnutrition fell by more than 80% in Bangladesh and Nepal, and immunisation among children dropped by 35% and 65% in India and Pakistan respectively...
It also estimates that there have been some 3.5 million additional unwanted pregnancies, including 400,000 among teenagers, due to poor or no access to contraception...
The interruption to health services also affected those suffering from other diseases - the report predicts an additional 5,943 deaths across the region among adolescents who couldn't get treated for tuberculosis, malaria, typhoid and HIV/Aids.
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Community-based strategies play a significant role in many health systems in low- and middle-income countries, especially in light of critical shortages in the health workforce. The term community health worker has been used to refer to volunteers and salaried, professional or lay health workers wit
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h a wide range of training, experience, scope of practice and integration in health systems. In the context of this study, we use the term community-based practitioner (CBPs) to reflect the diverse nature of these cadres of health workers.
CBPs provide preventive, promotive, curative and palliative services across a range of areas, including reproductive, maternal, newborn and child health, HIV, tuberculosis, malaria, control of other endemic diseases, and noncommunicable diseases. Significant evidence has emerged over the past two decades on their effectiveness, which has triggered interest in the potential to use their services to expand access to care, in particular in rural and underserved areas where deployment and retention of more qualified health workers is problematic. Calls have been made to integrate CBP programmes in human resources and health strategies, and to scale up rapidly the extent and coverage of CBP initiatives.
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