Mounting an effective international humanitarian response to a chemical, biological, radiological or nuclear (CBRN) event, especially if the response is undertaken on an ad hoc basis, would be extremely difficult and would pose many risks to the responders. The International Committee of the Red Cro...ss (ICRC) has created a competency-based capacity to respond to at least small-scale CBRN events, including a deployable capability to undertake operational activities. This involves informed assessments of CBRN risks, timely and competent decisions on how to respond, and effectively mobilizing appropriate resources to implement these decisions, through the creation of an emergency roster. In addition to the acquisition of technical expertise and material resources, the creation of such capacity requires the application of central processes, ensuring systematic management of CBRN response (including risk-based decision-making), standing operational procedures, and availability of and access to the necessary resources. Implementation of the ICRC's CBRN response framework as described in this article should be considered by any agency or other stakeholder preparing for international humanitarian assistance in CBRN events – especially if such events are related to armed conflict.
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MSF provides treatment for HIV and tuberculosis (TB) in more than 20 countries around the world. The report Burden sharing or burden shifting? How the HIV/TB response is being derailed examines the situation in nine countries where MSF runs programmes: Central African Republic, Democratic Republic ...of Congo, Eswatini, Guinea, Kenya, Malawi, Mozambique, Myanmar and Zimbabwe. With a focus on the financial resources available, this report highlights the current risks and gaps in HIV and TB service delivery in these countries.
Given the findings of gaps in diagnosis, prevention and care services and dwindling resources, MSF calls for a robust assessment of the needs and the resource capacity of each affected country, and calls on international donors to ensure that the financial burden is shared, rather than shifted onto those countries worst affected by the diseases.
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Pathogen genomic surveillance has become a priority for public health systems in recent years. Genomic sequencing is increasingly being used to characterize pathogens and monitor important public health priorities (e.g. poliovirus, influenza virus, Mycobacterium tuberculosis and Vibrio cholerae, ant...imicrobial resistance (AMR)). The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the role that sequencing plays in the surveillance of infectious diseases. Sequencing facilitates earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution and tailored development and evaluation of interventions to inform local to global public health decision-making and action. However, there remains a need to coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data (GSD) with clinical and epidemiological data to strengthen its utility.
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SIAPS Technical Report. This report summarizes key accomplishments and lessons learned in implementing SIAPS’ approach to improving IPC practices in four countries: South Africa, Namibia, Jordan, and Ethiopia. All activities address SIAPS’s overall objective to build or enhance national and faci...lity capacity to develop, implement, and monitor IPC programs by focusing on the principles of health systems strengthening.
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It is Zika virus (ZIKV) that most often causes these neurological effects it appears to be the only arbovirus than can cause congenital malformations such as microcephaly. In any case, more scientific tests are needed to establish the causal relationship between the virus and this malformation (7-10...).
This document is a practical tool designed to help health workers improve clinical diagnosis and provide timely care for patients infected
with the dengue, chikungunya, or Zika virus. It is intended mainly for
health workers in primary care facilities where laboratory diagnosis of
arboviruses is not always available. However, this guide may also be
very useful in hospitals that provide second- and third-level care, as it
describes the clinical manifestations of each of the three most important
arboviral diseases currently found in the Region, the elements for
differential diagnosis, and their clinical behavior.
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Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and comorbidities. Recognizing the significance of prim...ary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
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The guide is suitable and can be used for the following audiences:
1. nurses and other trained healthcare workers who can use this manual as a self-study tool and then incorporate its guidance into their practice;
2. governmental and non-governmental employers of lay and professional TB treatment ...adherence workers, who can provide training and guidance to their staff using the guidance in this manual;
3. TB clinicians, programme managers, policy makers and other leaders, to make them aware of the full range of interventions required by a person on TB treatment to complete his or her treatment and thus understand the gap that often exists in the support provided to patients;
4. people who, with enhanced capacity and support, can act as peer counsellors and supporters for people affected by TB. This can include family members who, in most contexts, play an important role in offering support to people with TB.
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Published: November 24, 2020 https://doi.org/10.1371/journal.pbio.3000938
Climate change is expected to have complex effects on infectious diseases, causing some to increase, others to decrease, and many to shift their distributions. There have been several important advances in understanding the ...role of climate and climate change on wildlife and human infectious disease dynamics over the past several years. This essay examines 3 major areas of advancement, which include improvements to mechanistic disease models, investigations into the importance of climate variability to disease dynamics, and understanding the consequences of thermal mismatches between host and parasites. Applying the new information derived from these advances to climate–disease models and addressing the pressing knowledge gaps that we identify should improve the capacity to predict how climate change will affect disease risk for both wildlife and humans.
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WHO has a unique combination of technical public health and scientific expertise, and a global operational footprint, with field offices in more than 150 countries. In 2020, this global, technical, and operational reach meant WHO was able to support countries around the world in every aspect of COVI...D-19 public health response, from surveillance and laboratory testing to maintaining essential health services in the most vulnerable and fragile contexts.
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HIV-1 drug resistance (HIVDR) genotyping is an essential component of the WHO global HIVDR surveillance strategy. Plasma “gold standard” specimen type for HIVDR genotyping, but its use may not be feasible in rural, remote areas in low- and middle-income countries, since preparing and storing it ...require personnel and laboratory infrastructure that are often lacking. An alternative specimen type is dried blood spots (DBS), which can be made without special laboratory processing. DBS are more easily transported than plasma because they can be shipped at ambient temperature as non-hazardous materials using regular mail or courier services.
3rd edition
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West Africa is experiencing the largest, most severe, most complex outbreak of Ebola virus disease in history. On 11 August 2014, WHO convened a consultation where the participants concluded that in the particular context of the current Ebola outbreak in West Africa, it is ethically acceptable to of...fer unproven interventions that have shown promising results in the laboratory and in animal models but have not yet been evaluat-
ed for safety and efficacy in humans as potential treatment or prevention
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In line with its decentralization principle, the Ethiopian Health Policy has achieved great progress in improving access to comprehensive HIV/AIDS services to the majority of the population. Both quality and coverage of services have improved significantlysince the initiation... of the free ART program in 2005. The role of health workforce in general and that of pharmacy professionals assumes a central position in these achievements. To further enhance accessibility and quality of services, capacity buildingof health cadres is critical. Therefore, this comprehensive HIV prevention, care and treatment training material is prepared with the primarily intention to build the capacity of pharmacy professionals at all levels so that they can contribute to the provision of HIV services.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from ...Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
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Int. J. Environ. Res. Public Health 2020, 17(23), 8849; https://doi.org/10.3390/ijerph17238849
The aim of building climate resilient and environmentally sustainable health care facilities is: (a) to enhance their capacity to protect and improve the health of their target communities in an unstable... and changing climate; and (b) to empower them to optimize the use of resources and minimize the release of pollutants and waste into the environment. Such health care facilities contribute to high quality of care and accessibility of services and, by helping reduce facility costs, also ensure better affordability. They are an important component of universal health coverage.
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The Committee discussed the implications for preparedness for smallpox-like events reflected by the ongoing COVID-19 pandemic. The Committee noted how quickly diagnostics and vaccines could be developed and deployed when resources and political will were abundant. This rapidity was also due to the f...act that the genetic sequence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had been shared worldwide. It was noted that in one country SARS-CoV-2 had been reconstructed in a laboratory from the viral genome sequence before the first case of COVID-19 had been reported, highlighting the benefits of synthetic biology technologies for accelerated development of diagnostics as well as the oft-described potential risks. Lessons learned about clinical care during the COVID-19 pandemic were also discussed.
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COVID-19 disproportionately affects the poor and vulnerable. Community health workers are poised to play a pivotal role in fighting the pandemic, especially in countries with less resilient health systems. Drawing from practitioner expertise across four WHO regions, this article outlines the targete...d actions needed at different stages of the pandemic to achieve the following goals: (1) PROTECT healthcare workers, (2) INTERRUPT the virus, (3) MAINTAIN existing healthcare services while surging their capacity, and (4) SHIELD the most vulnerable from socioeconomic shocks. While decisive action must be taken now to blunt the impact of the pandemic in countries likely to be hit the hardest, many of the investments in the supply chain, compensation, dedicated supervision, continuous training and performance management necessary for rapid community response in a pandemic are the same as those required to achieve universal healthcare and prevent the next epidemic.
BMJ Global Health2020;5:e002550. doi:10.1136/bmjgh-2020-002550
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This document aims to provide global guidance on poliomyelitis (polio) surveillance in the context of the COVID-19 pandemic. It comes as a technical complement to Polio eradication programme continuity, Immunization in the context of COVID-19 pandemic frequently asked questions, and is aligned with ...the Global Polio Eradication Initiative (GPEI) commitment to support the COVID-19 pandemic response.
It highlights the decision making framework to guide the level of polio surveillance activities at country level including; the measures to put in place to ensure a minimum level of polio surveillance in the field and in the laboratory, and the trigger to return to normal polio function.
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First published in 2020, this toolkit is intended for clinicians working in acute care, managing adult and paediatric patients with acute respiratory infection, including severe pneumonia, acute respiratory distress syndrome, sepsis and septic shock. The main objective is to provide key tools for us...e in the care of critically ill patients – from hospital entry to hospital discharge.
The 2022 updated version includes new tools and adapted algorithms, checklists, memory aids for COVID-19 and influenza, and the latest clinical evidence regarding clinical management of SARI. It is intended to help clinicians care for SARI patients: from epidemiology of severe acute respiratory infections, screening and triage, infection prevention and control, monitoring of patients, laboratory diagnosis, principles of oxygen therapy and different types of ventilation (invasive and non-invasive), as well as antimicrobial and immunomodulator therapies, to ethical and quality of care assessments.
The first edition is availbel in Ukrainian and Russian
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- The goal of diagnostic testing for Ebola and Marburg virus diseases is to identify cases to provide timely and appropriate care and to stop disease transmission.
- All individuals meeting the case definition for Ebola or Marburg virus diseases should be tested.
- The recommended sample type ...for testing for orthoebolaviruses and orthomarburgviruses is whole blood or plasma for living patients, and oral swab for deceased individuals.
- Laboratory confirmation of Orthoebolavirus and Orthomarburgvirus infections and further species identification should be done using nucleic acid amplification testing (NAAT).
- If a suspected case tests negative (living patient) and the blood was drawn less than 72 hours after symptom onset, a second test should be performed with blood drawn more than 72 hours after symptom onset.
- All manipulations in laboratory settings of samples originating from suspected, probable or confirmed cases of Ebola and Marburg virus diseases should be conducted with appropriate biosafety measures according to a risk-based approach.
- Whole or partial genome sequencing can be used to characterize viruses and complement epidemiologic investigations.
- Member States are strongly encouraged to share genetic sequence data (GSD) in publicly accessible databases.
- Member States are required to immediately notify the World Health Organization (WHO) under the International Health Regulations (IHR) 2005 of positive laboratory results.
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