Health Evidence Network synthesis report 53
Second Edition
AIDS Medicines and diagnostics services
July 2015
The aim of the operational framework is to ensure 1) accurate collection, handling, shipment and storage of specimens collected in countries implementing HIV drug resistance surveillance; and 2) the availability of quality-assured HIV genotyping laboratory services producing comparable and reliable ...results at the national, regional and global levels.
This publication updates the WHO HIVResNet HIV drug resistance laboratory operational framework published in 2017 and reflects technical and strategic developments over the past three years.
more
4th edition
The WHO Laboratory Biosafety Manual (LBM) has been in broad use at all levels of clinical and public health laboratories, and other biomedical sectors globally, serving as a de facto global standard that presents best practices and sets trends in biosafety.
LBM encouraged countries t...o accept and implement basic concepts in biological safety and to develop national codes of practice for the safe handling of biological agents in laboratories within their geographical borders.
This fourth edition of the manual builds on the risk assessment framework introduced in the third edition. A thorough, evidence-based and transparent assessment of the risks allows safety measures to be balanced with the actual risk of working with biological agents on a case-by-case basis.
This novel evidence- and risk-based approach will allow optimised resource use and sustainable laboratory biosafety and biosecurity policies and practices that are relevant to their individual circumstances and priorities, enabling equitable access to clinical and public health laboratory tests and biomedical research opportunities without compromising safety.
more
Transforming Health: Accelerating attainment of Health Goals | THE SECOND MEDIUM TERM PLAN FOR HEALTH
Advances have been made through expanded interventions delivered through five public health approaches: innovative and intensified disease management; preventive chemotherapy; vector ecology and management; veterinary public health services; and the provision of safe water, sanitation and hygiene. I...n 2015 alone nearly one billion people were treated for at least one disease and significant gains were achieved in relieving the symptoms and consequences of diseases for which effective tools are scarce; important reductions were achieved in the number of new cases of sleeping sickness, of visceral leishmaniasis in South-East Asia and also of Buruli ulcer.
The report also considers vector control strategies and discusses the importance of the draft WHO Global Vector Control Response 2017–2030.
more
A manual for health care providers.
This manual provides expert guidance on the laboratory techniques and procedures used in the diagnosis of Buruli ulcer, a disease caused by Mycobacterium ulcerans. Aimed at laboratory technicians and scientists working on this disease, the manual details the exac...t procedures to follow when performing a range of diagnostic tests. Recommended procedures, intended for use throughout the health system, are presented at levels appropriate for peripheral, district and central services and in accordance with the varying resources, skills and equipment typically found in countries where Buruli ulcer is endemic.
more
The National Guidelines for HIV-1 Viral Load Laboratory Testing support plans to scale up viral load (VL) testing to reach the 90-90-90 targets in India. This phased scale-up includes the setup of 70 additional VL testing laboratories nationally. These guidelines include laboratory design considerat...ions, a summary of VL technologies, and specimen collection and handling as well as transportation and storage guidance. Quality control and quality assurance requirements are described as well as laboratory safety issues. The guidelines also describe the VL laboratory network to be developed with supply chain management issues and commodities described. Annexes include laboratory registers and reporting forms.
more
Due to the anticipated significant rise in VL testing occasioned by Ghana’s adaptation of 2016 ART guidelines, it has become necessary to develop this VL scale-up and operational plan to assure complete client access to laboratory monitoring towards the achievement of the third 90 of the HIV care ...cascade. The plan will enhance VL testing, monitoring whilst improving the clinical and laboratory interface for improved client care.
more
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 113
This report synthesises the learning across the full programme of work. It presents the methods used, the context and policy motivations for developing EHBs; how they are being defined, costed, di...sseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced.
more
Senegal has adopted the World Health Organization–Joint United Nations Programme on HIV/AIDS recommended 90-90-90 targets.5 The adoption of this strategy means that the country is expected, by 2020, to have 90% of its population living with HIV diagnosed, 90% of all those diagnosed receiving susta...ined HIV treatment, and 90% of those receiving antiretroviral therapy having suppressed viral load measures.5 To achieve these outcomes, having good clinical laboratory services for diagnosis and follow-up will be critical.6 More specifically, investments will be needed to improve laboratory infrastructure, and to facilitate the access and availability of routine viral load and early infant diagnosis (EID) measures through the implementation of point-of-care (POC) diagnostic platforms along with an efficient and sustainable quality assurance programme.
more
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.
more
July 2021. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations and good practice statements within a public health, rights-based and person-centred approach.
These guidelines bring in... the most recent guidance on HIV testing strategies - the entry point for HIV prevention and treatment - and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
more
These guidelines provide a framework for effective action to facilitate access to safe and ethical
testing services for different population groups. The implementation of the a comprehensive
approach, known as HIV Testing Services (HTS) is cardinal as an effective package of services
that diminis...hes the impact of the HIV epidemic in our country. All forms of HTS adhere to
the 5Cs: Confidentiality, Counselling, Consent, Correct results and Connection, or linkage
to care, with all based within a human right context. In addition to the 5Cs, however, the
MOHCDGEC emphasizes the use of a variety of approaches to HTS that will reduce the
number of missed opportunities. These include Provider-Initiated Testing and Counselling
testing, Couple counselling and testing, Index testing, and infant and children counselling and
testing in alignment to the revised WHO guidelines. Furthermore, these guidelines accentuate
on the continual provision of integrated HTS service at all levels of the public and private
health service delivery system.
The HTS Providers, managers and other stakeholders
more
Policy Brief. 24 June 2022. This policy brief, one of two on the updated hepatitis C (HCV) guidelines, focuses on the new recommendations on simplified service delivery for a public health approach to HCV testing, care and treatment. These recommendations include decentralization, integration and ta...sk-sharing, in addition to the use of point-of-care (POC) HCV viral load assays and reflex viral load testing.
more
Buruli ulcer is caused by infection with Mycobacterium ulcerans. The disease is reported in more than 33 countries worldwide, but only about half of these countries regularly report data to WHO; most cases are reported from subregions of West and Central Africa. The mode of transmission is not known....
About half of those affected are children aged under 15 years; there is no gender difference. Diagnosis is based mainly on clinical and epidemiological characteristics. Of the four methods used for laboratory confirmation (microscopy, polymerase chain reaction (PCR), histopathology and culture), PCR is the most rapid and widely used. Other rapid methods for detection of mycolactone in lesions from suspected cases, such as fluorescent thin-layer chromatography, are under evaluation in four countries in Africa.
Research to develop point-of-care tests is in progress. Treatment of Buruli ulcer comprises 8 weeks of combined antibiotics (rifampicin and clarithromycin). Complementary therapies such as wound care, skin graft and prevention of disability are needed in some cases to ensure full recovery.
The target set by the World Health Organization (WHO) for control of Buruli ulcer is for countries to achieve a rate of case confirmation by PCR of at least 70%. All endemic countries have at least one PCR facility to support confirmation of cases. However, most countries in the WHO African Region have not been able to reach the target, and the rate of case confirmation has been declining
more
International commitment to eliminate trachoma as a public health problem worldwide is supported by resolution WHA51.11 of the World Health Assembly .1 Important progress towards this goal has been made by harnessing the mostly informal relationships that exist between partners including Member Stat...es, the World Health Organization (WHO), academic institutions, donors and nongovernmental organizations. Recognizing that work remains to be done and that the 2020 target2 for elimination is rapidly approaching, in February 2015 the WHO Department of Control of Neglected Tropical Diseases convened a group of academic institutions that had for many years helped WHO to implement its mandate on trachoma and to work towards establishing a Network of WHO collaborating centres (WHOCCs) for Trachoma. The report of that meeting has been published.
more
This WHO laboratory manual provides the most up to date methods and procedures for the laboratory identification of yellow fever virus infection in humans. It provides guidance on the establishment and maintenance of an effective laboratory providing routine surveillance testing for yellow fever, wh...ich operates within the WHO coordinated Global Yellow Fever Laboratory Network (GYFLaN) capable of providing confirmation of yellow fever infection reliably and timely. This second edition supersedes the first edition of the 2004 WHO manual for the monitoring of yellow fever virus infection.
more
Public health emergencies, including pandemics, highlight the need for health systems and services that are prepared, resilient and ready to respond to health security threats. Endorsed by Member States in 2023, the Asia Pacific Health Security Action Framework (APHSAF) is designed to engage m...ultisectoral actors in health security, and to reflect the complex nature of current and future public health emergencies. The Framework presents six interconnected, multisectoral domains of work that together form a comprehensive, multi-hazard health security system — emphasizing the One Health approach. The Framework also supports progress towards the Sustainable Development Goals and universal health coverage while meeting the responsibilities and obligations of the International Health Regulations (2005).
more