Millennium Development Goal 8E aims for affordable access to essential medicines. Essential medicines, as defined by WHO, are those that “satisfy the health-care needs of the majority of the population” and that should therefore “be available at all times in adequate amounts”. However, there... is a category of medicines that faces a unique challenge in terms of availability. These are the medicines governed by the international conventions on narcotic and psychotropic substances. “Controlled medicines” is the common definition for pharmaceuticals whose active principles are listed under the 1961 United Nations Single Convention on Narcotic Drugs as amended by the 1972 Protocol, such as morphine and methadone; the 1971 United Nations Convention on Psychotropic Substances, such as diazepam and buprenorphine; and the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, such as ergometrine and ephedrine. The conventions list substances in “Schedules” according to their different levels of potential for abuse and harm, and the commensurate severity of control measures to be applied by countries.
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ПРАКТИЧЕСКИЕ ШАГИ ПО ОБЕСПЕЧЕНИЮ ВСЕОБЩЕГО ДОСТУПА К КАЧЕСТВЕННОЙ ПОМОЩИ
Este documento presenta las principales conclusiones alcanzada durante la jornada El suicidio adolescente en la Argentina: recomendaciones de política pública.
En el encuentro un grupo de expertas y expertos, a partir de la evidencia obtenida en la investigación presentada por UNICEF y sus exper...iencias y conocimientos, dialogaron sobre los principales cuellos de botella en la implementación de acciones de prevención, atención, posvención y registro en el abordaje del suicidio adolescente, así como también sobre las estrategias de intervención priorizadas para su superación.
La metodología utilizada en la jornada se desprende del Sistema de Monitoreo de Resultados para la Equidad (MoRES, por sus siglas en inglés) como parte del enfoque en la equidad desarrollado por UNICEF.
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Abstract: Chagas disease is caused by infection with the protozoan Trypanosoma cruzi, and although over 100 years have passed since the discovery of Chagas disease, it still presents an increasing problem for global public health. A plethora of information concerning the chronic phase of human Chaga...s disease, particularly the severe cardiac form, is available in the literature. However, information concerning events during the acute phase of the disease is scarce. In this review, we will discuss the current status of acute Chagas disease cases globally, the immunological findings related to the acute phase and their possible influence in disease outcome, and reactivation of Chagas disease in immunocompromised individuals, a key point for transplantation and HIV invection management.
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Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where the disease is endemic, congenital CD (cCD...) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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Trypanosoma cruzi is the etiological agent of Chagas disease (CD), considered one of the most important parasitic infections in Latin America. Between 25 and 90 million humans are at infection risk via at least one of multiple infection mechanisms. Under natural conditions, the principal transmissio...n modes are transplacental or via one of more than 140 hematophagous triatomine bugs (Reduviidae: Triatominae). Triatomines acquire the parasite from mammal reservoirs due to their obligate blood-feeding (albeit triatomines can also feed on non-reservoir vertebrates such as birds and reptiles). The disease burden for CD in the Latin America and Caribbean region, based on disability-adjusted life-years (DALYs), is at least five times greater than that of malaria, and is approximately one-fifth that of HIV/AIDS. In recent decades, CD has extended to other continents outside natural reservoir or vector distributions due to human migration, with a minimum estimated 10 million individuals infected worldwide.
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Report of the third conference organized with ICONZ, DFID-RIU, Gates Foundation,
SOS, EU, TDR and FAO with the participation of ILRI and OIE
WHO headquarters, Geneva, Switzerland
23–24 November 2010
In this report we have tried to present the various issues, problems and
challenges that ...were discussed against the backdrop of the many inspiring
control programmes that were presented. Again and again these programmes
demonstrated how the NZDs are not so much re-emerging as rediscovered
– once a concerted effort is made to fi nd and treat patients – and how both
control and prevention rely on involving and inspiring the animal keeping
communities where they prevail.
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Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe, cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally kn...own as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
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The major neglected tropical diseases, Taenia solium taeniosis/cysticercosis and schistosomiasis caused by Schistosoma mansoni or S. haematobium are presumed to be widely distributed in Africa. Taenia solium taeniosis/ cysticercosis has been reported as an emerging disease in different regions of Af...rica [1, 2], but currently the exact distribution remains unclear. Reported prevalences of T. solium taeniosis and cysticercosis in African countries are not extensive and are further complicated by the lack of ‘gold standard’ tests for diagnosis.
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Taenia saginata is a zoonotic tapeworm that is of economic importance in countries where cattle are kept. The parasite is transmitted from human tapeworm carriers (taeniosis) to bovines (cysticercosis) by excretion of eggs or proglottids containing eggs into the environment via the stool. Bovines ca...n then ingest the eggs through contaminated feed or water. After ingestion, the eggs hatch and release oncospheres in the small intestines, where the oncospheres penetrate the intestinal wall to reach the blood circulation. This distributes them throughout the body, but primarily to muscle tissue, where they develop into cysticerci. For humans to become infected with T. saginata, raw or undercooked bovine meat or offal containing infective cysts must be consumed. Bovine cysticercosis has been associated with various environmental factors related to water sources, such as animals having access to surface water, flooding of pastures and proximity to wastewater sources.
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This report describes the activities of the WHO European Centre for Primary Health Care in 2022.The Centre accelerated face-to-face country support after the wake of the COVID-19 pandemic to support countries in engaging in analysis and diagnosis, developing strategies and policies, building capacit...y and tracking implementation progress and impact. The Centre delivered intensive support in the countries of the Universal Health Coverage Partnership. The Centre continued to develop policy guidance, publish good practices, have capacity-building activities and policy dialogues and solidified its signature product Let’s Talk Primary Health Care talk show platform. The highlight of 2022 was the launch of two WHO Primary Health Care Demonstration Platforms to facilitate cross-country experience exchange.
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L'OMS est un partenaire de confiance du Gouvernement du Niger depuis 1960. En tant que conseiller principal du gouvernement en matière de santé publique et présente dans toutes les régions du pays, l'OMS apporte un soutien technique et financier de qualité et bien coordonné dans le cadre des S...tratégies de Coopération convenues entre l'OMS et le gouvernement du Niger en fonction des priorités définies dans les différents politiques et programmes nationaux. La contribution de l’OMS s’inscrit également dans le cadre du Plan-cadre de Coopération des Nations Unies avec le Niger et des ODD au niveau mondial.
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There is an expanding market of no- and low-alcohol beverages (NoLos). However, their effects on global ethanol consumption and public health are still questioned. Policies and regulations about NoLos’ availability, acceptability and affordability are lacking and evidence about their benefits is l...imited. Concerns have been raised about the impact of NoLos in reducing alcohol consumption and its associated harm and the possible drawbacks and implications, such as misleading minors, pregnant women, abstainers or those seeking to stop drinking about their actual ethanol content. Further, there are concerns about the implications of NoLo branded products being displayed close to the brand’s main alcoholic beverages and their potential to subtly lead to new occasions of drinking. There is a need to monitor their consumption and impact on aggregated alcohol consumption to understand the public health implications of NoLos. The alcohol by volume content of NoLos must be defined, harmonised and clearly labelled. NoLo marketing needs to be regulated to protect children, pregnant women and those seeking to stop drinking. Fiscal and pricing policies to reduce the affordability of products with higher strengths of ethanol may favour a shift towards lower alcohol strength beverages.
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The chapter Dementia in Latin America and the Caribbean: Prevalence, Incidence, Impact, and Trends over Time, is part of the publication series titled “Decade of Healthy Aging: situation and challenges”. This document aims to provide an outline of the current situation in Latin America and the C...aribbean in respect of the prevalence and incidence of dementia and its impact on the health status of older people. As dementia is a significant global health problem which also has social and economic impacts this document highlights the importance of monitoring dementia in the region. The document evidences that dementia is one of the main contributors to dependence and disability in older people in Latin America and the Caribbean and, although its prevalence and incidence increase exponentially with age, it is not part of normal aging. Alzheimer’s disease is the most common dementia, and there is no cure for this condition, but with timely diagnosis is possible to ameliorate symptoms. It is important to assess what are the needs of people leaving with dementia and their families and to integrate dementia risk reduction strategies in pre-existing strategies for other non-communicable diseases. As shown in the report, despite the huge burden dementia is still underdiagnosed, and it is fundamental to better monitor its prevalence, incidence and the different societal impact that dementia can have. For that, it is crucial to promote the use of harmonized methodologies to address this information in a broader number of studies and countries in the region. This can contribute to the generation of direct actions to decrease dementia risk and lead to healthier lives for people with dementia and their families.
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The overall objective of the framework is to support WHO and Members States in meaningful engagement of people living with NCDs, and mental health and neurological conditions to co-create and enhance related policies, programmes and services. This framework will contribute to advancing understanding..., knowledge and action on meaningful engagement and related participatory approaches from an evolving evidence base. It provides practical guidance and actions for transitioning from intention to action to operationalize meaningful engagement.
The aim of the framework is to guide people working at WHO and in Member States in ensuring meaningful engagement with individuals with lived experience. WHO will advocate for, provide technical assistance and operationalize implementation at its three levels (headquarters, regional and country offices) and will support Member States in implementation at national level through established processes and procedures.
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L’objectif général de ce cadre est de permettre à l’OMS et à ses États Membres d’assurer la participation significative des personnes vivant avec des maladies non transmissibles, des problèmes de santé mentale et neurologiques, via un processus de cocréation et de renforcement des poli...tiques, programmes et services connexes. Sur la base de données factuelles en constante évolution, ce cadre contribuera à faire mieux comprendre la participation significative, et les mesures liées aux approches participatives connexes. Ce cadre expose des directives et les mesures pratiques à prendre pour traduire le concept de participation significative en action qui la mettra en œuvre. L’objectif de ce cadre est d’orienter les personnes travaillant à l’OMS et dans les États Membres dans le processus de participation significative des personnes ayant une expérience vécue. Ce faisant, l’OMS préconise la mise en œuvre de ce cadre à trois niveaux (Siège, bureaux régionaux et bureaux de pays), et fournit une assistance technique aux États Membres à la mise en œuvre de ce cadre au niveau national via les procédures établie
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El objetivo general del marco es apoyar a la OMS y a los Estados Miembros en lo relativo a la participación significativa de las personas con enfermedades no transmisibles y afecciones de salud mental y neurológicas con vistas a la creación conjunta y la mejora de políticas, programas y servicio...s que les afectan. Este marco contribuirá a avanzar en la comprensión, el conocimiento y las medidas adoptadas sobre la participación significativa y los enfoques participativos conexos a partir de una base empírica en evolución. En él se ofrece orientación práctica y medidas para pasar de la intención a la acción y hacer realidad la participación significativa. El objetivo del marco es orientar a quienes trabajan en la OMS y en los Estados Miembros para hacer realidad la participación significativa de las personas con experiencia vivida. La OMS promoverá, brindará asistencia técnica y pondrá en marcha el marco en sus tres niveles (Sede, oficinas regionales y oficinas en los países) y apoyará a los Estados Miembros en la aplicación a nivel nacional mediante los procesos y procedimientos establecidos.
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La Organización Panamericana de la Salud se complace en presentar la segunda edición del Manual de procedimientos para la vigilancia y el control de las leishmaniasis en la Región de las Américas, un instrumento de apoyo a las áreas de gestión y de servicios que trabajan con la leishmaniasis e...n los países de la Región. El manual tiene por objetivo ampliar los conocimientos sobre la enfermedad y aspira a ser una herramienta de trabajo para que el personal de salud y los equipos de gestión presten apoyo a los ministerios de salud en sus respectivos procesos de estructuración de los servicios de salud, así como en la optimización de las actividades para reducir la morbilidad y la mortalidad asociadas a las leishmaniasis. En esta segunda edición, se han puesto al día los datos epidemiológicos y las recomendaciones, en consonancia con las Directrices para el tratamiento de las leishmaniasis en la Región de las Américas, publicadas en el 2022. Además, se han revisado y complementado todos los capítulos para ofrecer a los países información actualizada que contribuirá a fortalecer la vigilancia, la asistencia y el control de los casos en seres humanos, vectores y reservorios.
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The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) project has conducted a multi-year, multi-country study that provides stark insights on the under-reported depth of the antimicrobial resistance (AMR) crisis across Africa and lays out urgent policy recommendations to addr...ess the emergency.
MAAP reviewed 819,584 AMR records from 2016-2019, from 205 laboratories across Burkina Faso, Cameroon, Eswatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe. MAAP also reviewed data from 327 hospital and community pharmacies and 16 national-level AMC datasets.
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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig...h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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