This policy brief aims to provide a review of the current progress on implementing the Kenya nat...ional action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target audience includes all those concerned with implementing actions to combat antimicrobial resistance in Kenya.
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This policy brief aims to provide a review of the current progress on implementing the Malawi na...tional action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target audience includes all those concerned with implementing actions to combat antimicrobial resistance in Malawi.
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This policy brief aims to provide a review of the current progress on implementing the Burkina F...aso national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target audience includes all those concerned with implementing actions to combat antimicrobial resistance in Burkina Faso.
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This policy brief aims to provide a review of the current progress on implementing the Mali nati...onal action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target audience includes all those concerned with implementing actions to combat antimicrobial resistance in Mali.
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This short paper aims to identify key evidence gaps in our knowledge of livestock- and fisheries-linked antimicrobial resistance in the developing ...world, and to document on-going or planned research initiatives on this topic by key stakeholders.
The antimicrobial resistant (AMR) infections in animals that are of most potential risk to human health are likely to be zoonotic pathogens transmitted through food, especially Salmonella and Campylobacter. In addition, livestock associated methicillin resistant Staphylococcus aureus (LA MRSA) and extended spectrum beta lactamase E. coli (ESBL E. coli) are emerging problems throughout the world.
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The Infection Prevention and Control (IPC) Legal Framework comes before the Specialized Technical Committee on Health and Drug Control for adoption... and endorsement. The IPC Legal Framework is designed to guide Member States in the review and strengthening of laws and policies that support IPC at both the national level and in healthcare facilities. In developing this IPC Legal Framework, the Africa Centres for Disease Control and Prevention (Africa CDC)
is furthering its mandates to harmonize disease control and prevention policies and promote the prevention and control of diseases by building capacity of public health institutions in Members States.
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Irresponsible pharmaceutical companies fuel the proliferation of superbugs through supply chain pollution, the European Public Health Alliance (EPHA) reports. ...box">The advocacy group uncovered lapses such as dirty production and inadequate waste disposal in the production of antimicrobials in China and India, which supplies most of the antimicrobials consumed in Europe. In a briefing detailing the pollution, the EPHA urges major purchasers of antibiotics to blacklist irresponsible pharmaceutical companies, demand that the industry clean up its supply chain, introduce greater transparency on the origin of antibiotics, and review and revise procurement policies from an ethics perspective.
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This document outlines the concept and content of the WHO people-centred approach to addressing antimicrobial ...edbox">resistance (AMR) in the human health sector. The proposed approach recognizes and aims to address the challenges and health system barriers people face when accessing health services to prevent, diagnose and treat (drug-resistant) infections. It puts people and their needs at the centre of the AMR response and guides policy-makers in taking programmatic and comprehensive actions to mitigate AMR in line with a proposed package of core interventions. These interventions are based on a review of four pillars and two foundational steps that are critical to overcome barriers faced by people and health systems in addressing AMR.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but mo...st have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidence map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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This document was prepared in response to a need to review and potentially update the current recommendations for the antibiotic treatment of both ...inpatient and outpatient management of severe acute malnutrition (SAM). The current recommendations (Table 1) are based on guidelines published in 2013 in the WHO Pocketbook for Hospital Care for Children, and the 2013 update on SAM (outpatient management). The global threat of increasing antimicrobial resistance and new data on efficacy and safety profiles requires a re-review of the current evidence to ensure recommendations are the most appropriate. The evidence base for the use of antibiotics in children presenting with uncomplicated SAM has been recently enlarged.
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WHO/Europe has launched a new guide, providing support to countries on how to apply behavioural and cultural insights (BCI) for health. It presents a simple step-wise approach, complemented by a rich collection of detailed considerations, tools and ...exercises. The guide is the first of its kind, specifically developed for use by public health professionals developing policies, services and communications informed by BCI across health topics.
Some of the most persistent public health challenges involve human behaviour. Using a BCI lens means that health policies, services and communications can be tailored to the needs and circumstances of people and communities, and thereby help combat these challenges. The new Tailoring Health Programmes (THP) guide describes how this can be done.
Building on several topic-specific guides that focused on applying BCI to routine and influenza vaccination and tackling antimicrobial resistance, as well as external evaluations and a rigorous peer-review process, this guide is the result of over a decade of work by WHO/Europe. The THP approach has already been adopted in over 20 countries and has received positive feedback from public health agencies.
“This guide is the culmination of a decade of work involving many colleagues at country, regional and global levels. The guide is our “BCI bible”, guiding our work with and in countries to help tackle persistent health challenges,” said Katrine Bach Habersaat, Regional Advisor for BCI at WHO/Europe.
Karina Godoy, Senior Analyst and National Focal Point for Behavioural Insights at the Public Health Agency of Sweden, who is employing the approach described in the guide across several health projects, comments: “The THP guide is easy to use and at the same time provides detailed guidance and inspiration where needed. We have decided to translate the document into Swedish and use the approach widely”.
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The Global Antibiotic Resistance Partnership (GARP)-Mozambique team, in partnership with the Center for Disease Dynamics, Economics & Policy (CDDEP...), has produced this report as part of a solid com-mitment to develop actionable policy proposals to tackle antibiotic resistance and improve appropriate antibiotic access. It is the result of a thorough review of published and unpublished data on antibiotic resistance and a long internal consultation effort that engaged academic scientists, health professionals and other stakeholders within Mozambique.
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Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, ...ute-to-highlight medbox">the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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These WHO guidelines which were updated in 2018, are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource... implications, and patient values and preferences.
The 2018 edition of the guidelines includes the revision of the recommendation regarding the use of 80% fraction of inspired oxygen (high FiO2) in surgical patients under general anaesthesia with tracheal intubation and the update of the section on implementation. Between 2017 and 2018, WHO re-assessed the evidence on the use of high FiO2 by updating the systematic review related to the effectiveness of this intervention to reduce SSI and commissioning an independent systematic review on adverse events potentially associated with it. Based on the updated evidence, the GDG decided to revise the strength of the recommendation from strong to conditional.
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First Global Patient Safety Challenge Clean Care is Safer Care
The WHO Guidelines on Hand Hygiene in Health Care provide health-care workers (HCWs), hospital administrators and health authorities w...ith a thorough review of evidence on hand hygiene in health care and specific recommendations to improve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present Guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population. Therefore, this concept applies to all settings where health care is permanently or occasionally performed, such as home care by birth attendants.
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The product of all this work is the Standard Treatment Guideline and Essential Medicines List of Common Medical Conditions in the Kingdom of Swazil...and. These systematically developed statements are designed to assist practitioners in making decisions about appropriate treatment for specific clinical conditions. They are meant to reflect expert consensus based on a review of current and published scientific evidence of acceptable approaches to diagnosis, man-agement, or prevention of specific conditions.It is enlightening to note that section A of the document contains the STG, and effort has been made to have the conditions commonly encountered in Swaziland classified according to systems. Written in simple, clear language, each section consists of a short definition followed by common symptoms and signs of the disease or condition and then management (pharmacological and nonpharmacological)
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The OIE has been working on the AMR issue for a long
time. In undertaking its role as a standard- setting organisation*
for animal health, includ...ing zoonoses, the OIE has developed
a wide range of international standards on antimicrobial
agents, in particular on responsible and prudent use.
These standards are regularly reviewed and updated
through the transparent and inclusive process of expert
advice and member consultation before presentation for
adoption to the World Assembly of Delegates from our
180 Member Countries each year. The OIE also works with
its Member countries in a comprehensive and continuous
capacity building process for their Veterinary Services.
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The global tripartite self-assessment survey of country progress in addressing antimicrobial resistance (AMR) is a component of a broader approach ...for monitoring and evaluation of the global action plan on AMR. This report analyses the results of the second tripartite self-assessment survey. It has been developed and run by the three Tripartite organizations (Food and Agriculture Organization of the United Nations (FAO), World Organisation for Animal Health (OIE) and World Health Organization (WHO)) and reflects progress in the human, animal (terrestrial and aquatic), plant, food safety and environmental sectors. 154 countries out of 194 WHO Member States responded to this round of the self-assessment survey – a response rate of 79.4%.
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