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Publication Years
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca
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l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide
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miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic char
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acteristics, and (2) the prevalence of self-reported blood pressure (BP) medication use among those with and without an indication for such medication as per World Health Organization (WHO) guidelines.
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Since the discovery of insulin nearly 100 years ago, advances in diabetes treatments and therapies have transformed the lives of people
with diabetes (PwD), notably reducing the daily burden of its management.
Newer technologies, including those driven by artificial intelligence, have the potentia
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l to further improve the quality of life of PwD and help
identify and diagnose people at risk of developing Type 2 diabetes and diabetes-related complications early. However, medical and technological advances alone are not enough to fix the diabetes challenge. It is also critical to acknowledge the complexity and the seriousness of diabetes, its impact on the quality of life and well-being of over 32 million PwD in the EU and the financial burden it represents for health systems and society at large.
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Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A
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Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
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Evidence shows that oral pre-exposure prophylaxis (PrEP) reduces the risk of contracting HIV during sexual intercourse by more than 90% when taken daily. It is for this reason the National HIV Prevention Strategy 2015-2020 (2018 Revision) emphasises the role of preexposure prophylaxis (PrEP) in
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reducing new HIV infections in Malawi.
The Ministry of Health has prioritised PrEP use among the populations most at-risk of HIV infection in Malawi: young women ages 10 to 24 years, sero-discordant couples, female sex workers, men who have sex with men, and other priority populations (such as members of the uniformed services, prisoners, and mobile populations).
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As Uganda builds back from the COVID-19 shock, the Ugandan government is strengthening its commitment to a more gender-inclusive and sustainable economy. This report supports these efforts by describing the gendered impacts of COVID-19 and provides recommendations for Ugandan policy makers and World
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Bank Group operations to ensure women’s participation in an inclusive and sustainable recovery. It presents gender-disaggregated data from three main sources: high-frequency phone surveys that track the impacts of the COVID-19 shock: one of Ugandan nationals conducted in June and one of refugees conducted in November 2020; interviews with 28 representatives of government institutions, development partners, and women’s organizations in Kampala and in rural areas; and a review of relevant policy and gray literature on climate change, the green economy, and women’s economic empowerment.
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This chapter of the AMP LLIN Mass Campaign Toolkit outlines the strategic communication approaches that are essential before, during and after long-lasting insecticide-treated net (LLIN) distribution campaigns. It emphasises the importance of setting up a national communications sub-committee under
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the leadership of the National Malaria Control Programme (NMCP) and the Ministry of Health (MoH) to coordinate advocacy, social mobilisation and behaviour change communication (BCC). The aim of these three components is to secure political and financial support, mobilise communities, and promote sustained net use through tailored, multi-channel messaging. Effective coordination and planning are critical for successful malaria prevention efforts.
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he United Nations Development Programme’s (UNDP) Gender Equality Strategy 2022-2025 has
been created during turbulent times. Multiple crises and risks are threatening the world and
we are witnessing an alarming backlash against women’s rights and gender equality. Since the
COVID-19 pandemic h
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it, women have been nearly twice as likely to lose their jobs compared to
men. Yet less than 20 percent of policy measures implemented by countries across the world have
addressed women’s economic insecurity. Gender inequality also takes a toll on men and other
affected groups. For men, rigid gender norms can fuel risky behaviours resulting in violence, poor
health, and lower life expectancy.
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This monograph presents 12 reports of successful programs serving children with special needs in various nations. The program locations and the program report titles and authors are as follows: (1) Austria: "Integration Models for Elementary and Secondary Schools in Austria" (Volker Rutte)
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; (2) China: "Integrated Education Project, Anhui Province" (Janet C. Holdsworth); (3) Ghana: "The Community-Based Rehabilitation Programme in Ghana" (Lawrence Ofori-Addo); (4) Guyana: "Involvement of Volunteers, Parents and Community Members with Children with Special Needs" (Brian O'Toole); (5) India: "Teacher Development Initiative To Meet Special Needs in the Classroom" (N. K. Jangira and Anupam Ahuja); (6) Jamaica: "Early Intervention and Education Initiatives in Rural Areas" (M. J. Thorburn); (7) Jordan: "The Role of Institutions in Community-based Rehabilitation and in Community-based Special Education" (Andrew L. de Carpentier); (8) Jordan: "The Resource Room at the Amman National School" (Hala T. Ibrahim); (9) Netherlands: "Individual Integration of Children with Down's Syndrome in Ordinary Schools" (Trijntje de Wit-Gosker); (10) Norway: "In Harmony We Learn" (Marna Moe); (11) International: "INITIATIVES for Deaf Education in the Third World" (Andrew L. de Carpentier); and (12) Sri Lanka: "The Integrated Education of Visually Impaired Children in Sri Lanka" (B. L. Rajapakse).
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One of the principles underpinning the delivery of all essential services and coordination of those services is the “survivor-centered approach”, which places the human rights, needs, and wishes of women and girl survivors at the centre of service delivery.
A key challenge faced by many entit
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ies working to end violence against women is ensuring that survivors’ voices and inputs are incorporated into policies, practices, and procedures on response. Survivors have diverse needs and face different risks. Not all women and girls experience violence in the same way. An effective intervention takes into account the realities of their unique circumstances, addresses individual needs, and reduces the risk for further harm and suffering.
UN Women, together with Global Rights for Women, have developed “Safe consultations with survivors of violence against women and girls”, which is designed to provide practical steps, safety measures, and actions that government agencies, civil society and survivor organizations, and United Nations’ entities can take to incorporate survivors' voices into systemic reform efforts, through safe and meaningful consultations.
This guidance is intended to help policymakers develop survivor-centered programming on ending violence against women and girls that meets the needs of diverse groups of women and girls, including those who are at higher risk of experiencing violence and discrimination. It is applicable to programming across the health, justice and policing, and social services sectors, as well as coordination of these sectors, and will help improve the standard and delivery of essential services for women and girls who have experienced violence.
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Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultu
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ral practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess
and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex; and their natural, social and personal domains are highly variable due to diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of
light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such altitude, latitude and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment
and pollution, as well as by socioeconomic status and social networks. These attributes of the
social environment shape lifestyle choices that significantly modify CVD risk. An understanding
of how different domains of the environment, individually and collectively, affect CVD risk could
lead to a better appraisal of CVD, and aid in the development of new preventive and therapeutic
strategies to limit the increasingly high global burden of heart disease and stroke.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t
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hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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Globally, more people live in urban areas than in rural areas, with 55 % of the world’s population residing in urban areas in 2018. In 1950, 30 % of the world’s population was urban, and by 2050, 68 % of the world’s population is projected to
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be urban.
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This study assesses the prevalence and awareness of diabetes in urban and rural areas of Mozambique and describes its management.
Key concern areas of various water supply technologies and users’ water handling practice responsible for water contamination and measures required to avoid such contamination are depicted in this manual using simple language and real life photographs. Water users will be able to easily perceive
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whether water from their supply options are getting contaminated or not by comparing with the pictures and learn about proper water safety measures. Concepts and practice of urban and rural users towards water safety plan will be improved by using this manual.
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La thèse de Yobouet Inès Kouakou, soutenue à l’Université Claude Bernard Lyon 1, porte sur le traitement d’urgence du paludisme sévère chez l’enfant à l’aide d’une administration intranasale d’artésunate. L’objectif principal de ce travail est d’explorer, in vitro, la voie na
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sale comme alternative à la voie intra-rectale recommandée actuellement en pré-hospitalier. L’étude démontre la non-toxicité de formulations d’artésunate sur un modèle de muqueuse nasale humaine, bien que la perméation observée reste faible. Des pistes sont proposées pour améliorer cette perméation, notamment par l’optimisation galénique. La thèse inclut également une revue de la pharmacocinétique de l’artésunate et le développement de méthodes de dosage simples et peu coûteuses, adaptées aux laboratoires à ressources limitées. Ce travail s’inscrit dans une démarche de lutte contre le paludisme, notamment en zones rurales où l’accès aux soins reste difficile.
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This set of malaria awareness posters, created by the National Institute for Communicable Diseases (NICD), provides the general public in South Africa with clear visual messages about malaria prevention, symptoms and the importance of early treatment. Designed for community outreach, the posters enc
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ourage key protective behaviours such as using bed nets, seeking prompt medical attention, and recognising the signs of infection.
Accessed on 20/06/2025.
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The article focuses on "The State of the World’s Children 2023" report published by UNICEF. It highlights the critical role of vaccines in saving lives and the challenges in global immunization efforts, especially for marginalized and underserved children. The report emphasizes the impact of COVID
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-19 on routine immunization, leaving millions of children unprotected from preventable diseases. It calls for urgent measures to restore and improve vaccination coverage, ensure equity in vaccine access, strengthen primary healthcare systems, and build trust in vaccines. The report also advocates for innovations and sustainable funding to achieve immunization for every child.
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The article focuses on "The State of the World’s Children 2023" report published by UNICEF. It highlights the critical role of vaccines in saving lives and the challenges in global immunization efforts, especially for marginalized and underserved children. The report emphasizes the impact of COVID
...
-19 on routine immunization, leaving millions of children unprotected from preventable diseases. It calls for urgent measures to restore and improve vaccination coverage, ensure equity in vaccine access, strengthen primary healthcare systems, and build trust in vaccines. The report also advocates for innovations and sustainable funding to achieve immunization for every child.
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