Reducing the humanitarian impact of the use of explosive weapons in populated areas is a key priority for the United
Nations, the International Committee of the Red Cross (ICRC), civil society and an increasing number of Member States.
The United Nations Secretary-General has expressly called on... parties to conflict to avoid the use in populated areas of
explosive weapons with wide-area effects.
While the use of explosive weapons in populated areas may in some circumstances be lawful under international
humanitarian law (IHL), empirical evidence reveals a foreseeable and often widespread pattern of harm to civilians,
particularly from explosive weapons with wide-area effects.
Many types of explosive weapons exist and are currently in use. These include air-delivered bombs, artillery projectiles,
missiles and rockets, mortar bombs, and improvised explosive devices (IEDs). Some are launched from the air and
others are surface launched. Whilst different technical features dictate their accuracy of delivery and explosive effect,
these weapons generally create a zone of blast and fragmentation with the potential to kill, injure or damage anyone
or anything within that zone. This makes their use in populated areas – such as towns, cities, markets and camps for
refugees and displaced persons or other concentrations of civilians – particularly problematic. The problems increase
further if the effects of the weapon extend across a wide-area either because of the scale of blast that they produce; their
inaccuracy; the use of multiple munitions across an area; or a combination thereof.
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Orientación para las Sociedades Nacionales de las Américas
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 most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e 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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TB situation in vulnerable populations. Rev. Nac. (Itauguá) vol.13 no.1 Itauguá jun. 2021
La pandemia de covid-19 ha afectado la detección y tratamiento de pacientes con TBC en Paraguay que lejos de ser una enfermedad erradicada, es motivo de preocupación sanitaria y sigue afectando a miles de ...personas, si bien se inician actividades de campo con apoyo del PNCT para la búsqueda activa, seguimiento de casos y control de contactos en comunidades indígenas y asentamientos, estas tareas no son continuas debido al aumento de los casos de covid-19 en el país, que favorece el temor a acudir a los hospitales para el diagnóstico, a sus controles e incluso se ve afectado el retiro de los medicamentos. En el marco de la pandemia, es probable que aumenten los fracasos terapéuticos con el consiguiente desenlace fatal, por lo que debe hacerse una revisión de las estrategias dirigidas a poblaciones vulnerables con un compromiso verdadero del sector político, sumado a una fuerte colaboración multisectorial e intercultural para lograr el fin de la TBC
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Este instructivo se aplica a la implementación del SNVS 2.0 para la notificación de pruebas rápidas para sífilis, vih y/o hepatitis b y c; en los puntos de atención para personas usuarias del sistema de salud. Éstos pueden ser centros de salud del primer nivel de atención, locales o espacios ...que brindan las organizaciones de la sociedad
civil, campañas en la vía pública, espacios educativos, etc. No necesariamente refiere al contexto de los laboratorios convencionales. Se caracterizan por la devolución rápida del resultado a la persona testeada y la posibilidad de tomar una decisión oportuna de inciar un tratamiento y/o proponer medidas preventivas.
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Nurses are critical to deliver on the promise of “leaving no one behind” and the global effort to achieve the Sustainable Development Goals (SDGs). They make a central contribution to national and global targets related to a range of health priorities, including universal health coverage, mental... health and noncommunicable diseases, emergency preparedness and
response, patient safety, and the delivery of integrated, people-centred care.
No global health agenda can be realized without concerted and sustained efforts to maximize the contributions of the nursing workforce and their roles within interprofessional health teams. To do so requires policy interventions that enable them to have maximum impact and effectiveness by optimizing nurses’ scope and leadership, alongside accelerated investment
in their education, skills and jobs. Such investments will also contribute to the SDG targets related to education, gender, decent work and inclusive economic growth.
This State of the world’s nursing 2020 report, developed by the World Health Organization (WHO) in partnership with the International Council of Nurses and the global Nursing Now campaign, and with the support of governments and wider partners, provides a compelling case on the value of the nursing workforce globally.
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The Western Pacific Region is the largest and most diverse region in the world, made up of 37 countries and territories in the Pacific, Oceania and parts of Asia, with a population of more than 1.9 billion people stretching over an area from China and Mongolia in the north to New Zealand in the sout...h. In 1999, 22 countries and territories in the Pacific joined together and launched the Pacific Programme to Eliminate Lymphatic Filariasis. Shortly after, the Global Programme to Eliminate Lymphatic Filariasis was launched in 2000. In 2004, 12 countries in the Asia subregion of the Western Pacific Region and Southeast Asian Region joined and developed the Mekong-Plus Strategic Plan for Elimination of Lymphatic Filariasis. Since then, significant efforts have been made by all endemic countries, with annual mass drug administration (MDA) as a principal strategy, through strong partnership with the WHO and other donors and partners. As a result, by the end of 2019, 10 of 22 endemic countries in the region, including 8 of 16 countries in the Pacific and 2 countries in the Asia subregion, achieved WHO validation for elimination of lymphatic filariasis (LF) as a public health problem. All the other countries are either progressing with post-MDA surveillance or accelerating efforts by adoption of the new triple drug therapy strategy and enhancement of MDA campaigns to tackle persistent transmission. Some 85% of the originally endemic implementation units have stopped MDA and the number of people requiring MDA for LF in the Western Pacific Region was reduced by 72% from 2000 to 2018. This paper reviews the progress, key success factors and remaining challenges and indicates the way forward to achieve LF elimination in the Western Pacific Region.
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Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the
South of the United States. It is an important cause of early mortality and morbidity, and it is associated with poverty and stigma. A third of
the cases evolve into chronic... cardiomyopathy and gastrointestinal disease. The infection is transmitted vertically and by blood/organ
donation and can reactivate with immunosuppression. Case identification requires awareness and screening programmes targeting the
population at risk (women in reproductive age, donors, immunocompromised patients). Treatment with benznidazole or nifurtimox is most
effective in the acute phase and prevents progression to chronic phase when given to children. Treating women antenatally reduces but does
not eliminate vertical transmission. Treatment is poorly tolerated, contraindicated during pregnancy, and has little effect modifying the
disease in the chronic phase. Screening is easily performed with serology. Migration has brought the disease outside of the endemic
countries, where the transmission continues vertically and via blood and tissue/organ donations. There are more than 32 million migrants
from Latin America living in non-endemic countries. However, the infection is massively underdiagnosed in this setting due to the lack of
awareness by patients, health authorities and professionals. Blood and tissue donation screening policies have significantly reduced
transmission in endemic countries but are not universally established in the non-endemic setting. Antenatal screening is not commonly
done. Other challenges include difficulties accessing and retaining patients in the healthcare system and lack of specific funding for the
interventions. Any strategy must be accompanied by education and awareness campaigns directed to patients, professionals and policy
makers. The involvement of patients and their communities is central and key for success and must be sought early and actively. This review
proposes strategies to address challenges faced by non-endemic countries
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The Onchocerciasis Control Programme in West Africa (OCP) undertook regional and large scale frght against onchocerciasis in West Africa in 1974 using a vector control strategy. By 2002 OCP had succeeded in eliminating the disease as a public health, socio-economic and development problem in 10 out ...of I I countries. This campaign was highly technical and expensive. ln 1987, Merck & Co.,lnc. committed themselves to provide ivermectin free of charge for as long as needed to onchocerciasis endemic countries. This made it possible to envrsage the extension of onchocerciasis control activities to the remaining endemic countries in Africa.
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This article considers the current public health perspective on cutaneous leishmaniasis (CL) and its implications for incidence, prevalence, and global burden of disease calculations. CL is the most common form of leishmaniasis and one of a small number of infectious diseases increasing in incidence... worldwide [1] due to conflict and environmental factors in the Middle East (“Old World”) and the Americas (“New World”)—regions where it is most prevalent.
Recently, the disease has reached hyperendemic levels in the conflict zones of the Syrian Arab Republic, Iraq, and Afghanistan while simultaneously affecting refugees from those regions . Nevertheless, CL is not seen as a priority for policymakers because it is not life limiting. This is evidenced by a lack of commitment in recent years to preventive campaigns and patient provision (limited diagnostic capacity, knowledge of treatment, drug availability) in a number
of endemic countries.
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Yaws is targeted for eradication by 2030, using a strategy based on mass drug administration (MDA) with azithromycin. New diagnostics are needed to aid eradication. Serology is currently the mainstay for yaws diagnosis; however, inaccuracies associated with current serological tests makes it difficu...lt to fully assess the need for and impact of eradication campaigns using these tools. Under the recommendation of the WHO Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases(NTDs), a working group was assembled and tasked with agreeing on priority use cases for developing target product profiles (TPPs) for new diagnostics tools.
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In 2018, we are celebrating 20 years of progress in eliminating trachoma, the world’s leading infectious cause of blindness. Set up in 1998 by Pfizer Inc. and the Edna McConnell Clark Foundation, the International Trachoma Initiative (ITI) supports Ministries of Health in over 30 countries around ...the world by making Zithromax® available for use in public health campaigns to eliminate trachoma. The 20th anniversary of our founding gives us an opportunity to reflect on the distance we’ve traveled in fighting this disease, and raise the ambition for accelerating to a world where diseases like trachoma are a distant memory. We have not traveled alone these past 20 years – a broad coalition of actors including NGOs, the World Health Organization (WHO), Ministries of Health, health workers, and community members have made these incredible achievements possible. Our 20th anniversary gives us an opportunity to celebrate this coalition of partners, colleagues, and friends
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In 2014, an estimated 40 million women of reproductive age were infected with Schistosoma haematobium, S. japonicum and/or S. mansoni. In both 2003 and 2006, the World Health Organization (WHO) recommended that all schistosome-infected pregnant and breastfeeding women be offered treatment, with praz...iquantel, either individually or during treatment campaigns. In 2006, WHO also stated the need for randomized controlled trials to assess the safety and efficacy of such treatment. Some countries have yet to follow the recommendation on treatment and many programme managers and pregnant women in other countries remain reluctant to follow the recommended approach.
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This regional action plan provides a broad framework for the regional level to assist governments in accelerating the implementation of existing international, regional and national commitments on ending FGM. Formulating the plan has provided an opportunity for the region to identify broad prioritie...s, initiate strategic actions and determine responsibilities among different actors. It also ensures that anti-FGM campaign activities are seen not as standalone efforts but rather as an integral part of the African Union’s discussions, in line with the African Union initiative on eliminating FGM (Saleema Initiative)
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc...e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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For the past years, Haiti has been engulfed in a socioeconomic, political, and humanitarian crisis that has reached critical levels since mid-September 2022 with the intensification of gang violence and social unrest. The widespread insecurity and
political instability have drastically affected the... country’s access to essential goods and services, including food, water, and health. The current fuel supply crisis has affected the water and electricity supply to the population, health centers, and hospitals. Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services.
In parallel, the public health system and international partners face limited response capacity due to reduced international personnel in Haiti, logistics issues, and difficulties in importing supplies. Indeed insecurity, roadblocks, and lockdowns are affecting the importation of internationally procured goods, which may slow the arrival of essential lifesaving supplies to support cholera response efforts. This scenario is particularly problematic, as cholera recently resurfaced in early October.
Armed gangs now control over 60% of the metropolitan area of Port-au-Prince, affecting at least 1.5 million people, and have expanded their influence outside of the capital city, interrupting vital humanitarian programs in most of the national territory,
including COVID-19 vaccination campaigns.
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Ageism exists when “age” is used to categorize individuals and create social divisions, with ensuing injustice and harm and lack of solidarity across generations. Ageism is highly detrimental to our health and well-being and imposes a heavy cost on societies. The World Health Organization (WHO) ...was requested to develop, in cooperation with partners, a global campaign to combat ageism.
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Vaccines are powerful weapons in the fight against pandemic viruses as shown by responses to both the 2009 H1N1 influenza and the COVID-19 pandemics. However, planning for accessing, allocating and deploying vaccines in a pandemic situation is a complex endeavour, beset with multiple challenges at a...ll levels – local, regional and global. The World Health Organization (WHO) and its partners have prepared this revised guidance document to assist countries update their national deployment and vaccination plans (NDVPs) by leveraging global learnings from past pandemic responses, including the recent COVID-19 vaccination effort. The development and testing of a NDVP would not only advance pandemic preparedness efforts but would also have benefits in terms of increasing national capabilities to manage other health emergencies which require emergency vaccination campaigns.
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