[Preface]. For more than forty years Primary Health Care (PHC) has been recognized as the cornerstone of an effective and responsive health system. The Alma-Ata Declaration of 1978 reaffirmed the right to the highest attainable level of health, with equity, solidarity and the right to health as its ...core values. It stressed the need for comprehensive health services, not only curative but services that addressed needs in terms of health promotion, prevention, rehabilitation and treatment of common conditions. A strong resolutive first level of care is the basis for health system development [...] The Pan American Health Organization/World Health Organization (PAHO/WHO) has supported the countries in the establishment of interprofessional PHC teams, in the transformation of health education and in building capacity in the strategic planning, and management of human resources for health. Nursing can play a critical role in advancing PHC. New profiles such as the advanced practice nurses, as discussed in this document, can be fundamental in this effort, and in particular, in health promotion, disease prevention and care, especially in rural and underserved areas.
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The issue of Antimicrobial resistance has become one of the most substantial health issues, prompting the World Health Assembly (WHA) to urge Member States to finalise tailor made national action plans by May 2017, aligning them with objectives of the Global Action Plan (GAP). These cover awareness,... surveillance and research, hygiene infection prevention & control, optimal use of antimicrobial medicines and economic case for sustainable investment. Indonesia, by virtue of its geographical terrain and complex interactions with diverse stakeholders, indicates a higher burden of AMR. Most of the country’s data currently relies on local studies conducted by labs and universities. To get a more accurate estimate of the situation, one has to rely on results from the Regional Resistance Surveillance Programme. By undertaking such measure, Indonesia would acquire data to detect AMR trends at a national level.
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Northern: Chandigarh, Delhi, Haryana, Himachal Pradesh, Jammu & Kashmir, Punjab, Rajasthan, and Uttarakhand
Central: Chhattisgarh, Madhya Pradesh and Uttar Pradesh
Eastern: Andaman & Nicobar, Bihar, Jharkhand, Odisha and West Bengal
This technical document consists of epidemiological ...profiles (fact-sheets) for States and districts based on information available from multiple data sources including the HIV Sentinel Surveillance (HSS) and the Integrated Biological and Behavioural Surveillance (IBBS). Given the need for focussed prevention efforts in low/high prevalence and vulnerable States/districts, the information presented will be useful for policy makers, program planners at national/State/ district level, researchers, and academicians in identification of areas for priority attention and also to derive meaningful conclusions for programme planning, implementation, monitoring and scale-up. This document will be a quick reference for the HIV/AIDS situation in a State/district, risk and safe behaviour of the high risk groups, their level of knowledge about STIs and HIV/AIDS, experience of violence, HIV testing and ART awareness and exposure to HIV/AIDS prevention.
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West: Drada & Nagar Haveli, Daman & Diu, Goa, Gujarat, Maharashtra
South: Andhra Pradesh & Telangana, Karnataka, Kerala, Puducherry, Tamil Nadu
This technical document consists of epidemiological profiles (fact-sheets) for States and districts based on information available from multiple d...ata sources including the HIV Sentinel Surveillance (HSS) and the Integrated Biological and Behavioural Surveillance (IBBS). Given the need for focussed prevention efforts in low/high prevalence and vulnerable States/districts, the information presented will be useful for policy makers, program planners at national/State/ district level, researchers, and academicians in identification of areas for priority attention and also to derive meaningful conclusions for programme planning, implementation, monitoring and scale-up. This document will be a quick reference for the HIV/AIDS situation in a State/district, risk and safe behaviour of the high risk groups, their level of knowledge about STIs and HIV/AIDS, experience of violence, HIV testing and ART awareness and exposure to HIV/AIDS prevention.
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Training for staff working at DR-TB management centres.
Training modules
Health care waste management (HCWM) and infection prevention and control (IPC) represent serious concerns for HIV programs. Improperly handled infectious health care waste poses risks to health workers, their clients, the community, and the environment. Improper injection practices can lead to new H...IV and other infections for health workers and clients. Beginning in 2015, AIDSFree continued the work started by the Government of Nigeria and USAID in 2004 to strengthen activities in IPC and HCWM. This report describes AIDSFree's results over 15 months of implementation of HCWM and IPC activities in seven Nigerian states prioritized by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR)
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The new treatment recommendations that extend the 2018 treat all recommendation for adults with chronic HCV infection to include adolescents and children down to 3 years, and to align the existing recommended pangenotypic direct-acting antiviral (DAA) regimens (SOF/DCV, SOF/VEL and G/P) for adults, ...to those for adolescents and children. This alignment is expected to simplify procurement, promote access to treatment among children in low- and middle-income countries and contribute to global efforts to eliminate the disease
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The meningitis road map has been designated as a flagship global strategy of the WHO’s Thirteenth General Programme of Work, 2019–2023 and is an essential component in achieving universal health coverage.
The road map will reinforce and combine with wider initiatives, such as those aimed at s...trengthening primary health care and health systems, increasing immunization coverage, improving global health security, fighting antimicrobial resistance and advocating for the rights of persons with disabilities. It will complement other global control strategies, such as those addressing sepsis, pneumonia, tuberculosis and HIV. Implementation will be a challenge for all countries across the world, but especially in resource-poor settings where the burden of meningitis is greatest. The targets for the visionary and strategic goals will be adapted to regional and local contexts.
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The goal of the strategy is to prevent seasonal influenza, control the spread of influenza from animals to humans, and prepare for the next influenza pandemic.
The new strategy is the most comprehensive and far-reaching that WHO has ever developed for influenza. It outlines a path to protect popul...ations every year and helps prepare for a pandemic through strengthening routine programmes.
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An estimated 59 000 people die from rabies each year. That’s one person every nine minutes of every day, 40% of whom are children living in Asia and Africa. As dog bites cause almost all human cases, we can prevent rabies deaths by increasing awareness, vaccinating dogs to prevent the disease at i...ts source and administering life-saving treatment after people have been bitten. We have the vaccines, medicines, tools and technologies to prevent people from dying from dog-mediated rabies. For a relatively low cost it is possible to break the disease cycle and save lives
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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Recommendations for Tuberculosis Screening Before Initiation of TNF-α-Inhibitor Treatment in Rheumatic Diseases
Diel R et al. Empfehlungen für das Tuberkulosescreening vor Gabe von TNF-α-Inhibitoren… Pneumologie 2009; 63: 329–334
National Tuberculosis Control Program; Mycobacterial Disease Control National AIDS/STD Program
Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of... the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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The World Heart Federation (WHF) has been advocating globally for stronger
legislation and policy regarding cardiovascular disease (CVD) for many years. Now, as focus shifts from global to national progress, we call on members and colleagues to advocate for greater action on CVD in your local setti...ngs. This ‘Road to 2018 Toolkit’ provides World Heart Federation members with information
and specific, practical tools to support national CVD advocacy, especially around the United Nations High-Level Meeting on NCDs in 2018.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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This document offers suggested risk communication actions in relation to Zika virus infection and other health issues linked to this disease. It is directed toward ministers of health and other health sector actors who, with their national (multidisciplinary) teams for communication and social mobil...ization, will be able to adapt the provided information to the needs of their countries and audiences.
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Schistosoma haematobium is a parasitic digenetic trematode responsible for schistosomiasis (also known as bilharzia). The disease is caused by penetration of the skin by the parasite, spread by intermediate host molluscs in stagnant waters, and can be treated by administration of praziquantel. Schis...tosomiasis is considered to be an important but neglected tropical disease.
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The goal of the United States Government for the President's Emergency Plan for AIDS Relief (PEPFAR) in Mozambique is to support country efforts to achieve epidemic control by 2020 through evidence-based policies and interventions to drive progress and save
lives. This document details PEPFAR's op...erational plan in Mozambique.
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Some observers have described the coronavirus pandemic as an 'Anthropocene disease,' thereby highlighting its connection with this new ecological era that is characterised by the considerable pressure human activities are exerting on ecosystems and the consequences on public health, society and the ...environment. This article focuses on the recent emergence of the 'Planetary Health' paradigm. Launched by the Rockefeller Foundation and the medical journal The Lancet, Planetary Health is one of the most ambitious attempts in recent years to systematize global health in the Anthropocene. While recognising the interest and necessity of reflecting on human health and the health of the planet, this article aims to show, however, that the Planetary Health paradigm is problematic and aporetic for two reasons. First, because it is based on a scientistic and depoliticised conception of the Anthropocene, which obscures capitalism's responsibility for the contemporary global and, especially, ecological crisis. Second, because this conception leads to a promotion of solutions that are essentially based on the financialization and technoscientific management of the living world - precisely the underlying cause of the degradation of ecosystems and living conditions that created the Anthropocene in the first place. A different kind of 'planetary health' remains possible and desirable.
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