The United Nations Framework Convention on Climate Change (UNFCCC) established its Financial Mechanism to facilitate the provision and transfer of resources from developed to developing countries. The Global Environment Facility became the first operating entity of the Financial Mechanism after the ...Conference of the Parties (COP) to the UNFCCC, and the GEF Council agreed to a Memorandum of Understanding (MOU) in 1996. This agreement placed the GEF under the guidance of the COP, as Article 11 of the Convention states that the Financial Mechanism “shall function under the guidance of and be accountable to the Conference of the Parties, which shall decide on its policies, program priorities and eligibility criteria related to this Convention.”
The yearly COPs have provided an opportunity for Parties to update and renew their guidance to the GEF. To date, there have been 145 UNFCCC COP decisions and 526 paragraphs that offer guidance to the GEF (see Table 1). In addition, the Conferences of the Parties serving as the meeting of the Parties to the Paris Agreement (CMA) have issued 40 decisions and 115 paragraphs as guidance to the GEF (see Table 2). Key areas of Convention guidance have included: the GEF’s role as an operating entity of the Financial Mechanism, including the Paris Agreement; the GEF’s institutional and procedural reform; transparency and access to GEF funds; country engagement and empowerment; reporting on greenhouse gas (GHG) inventories; support for technology transfer; and ongoing programming in mitigation and adaptation.
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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 ...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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The article "Time to Align: Development Cooperation for the Prevention and Control of Non-Communicable Diseases" argues for greater international cooperation and investment in addressing non-communicable diseases (NCDs), especially in low- and middle-income countries. Traditionally, global health fu...nding has focused on infectious diseases, but the growing burden of NCDs—such as cardiovascular diseases, cancer, and diabetes—necessitates new approaches to development assistance.
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This global status report on prevention and control of NCDs (2014), is framed around the nine voluntary global targets. The report provides data on the current situation, identifying bottlenecks as well as opportunities and priority actions for attaining the targets. The 2010 baseline estimates on N...CD mortality and risk factors are provided so that countries can report on progress, starting in 2015. In addition, the report also provides the latest available estimates on NCD mortality (2012) and risk factors, 2010-2012.All ministries of health need to set national NCD targets and lead the development and implementation of policies and interventions to attain them. There is no single pathway to attain NCD targets that fits all countries, as they are at different points in their progress in the prevention and control of NCDs and at different levels of socioeconomic development. However all countries can benefit from the comprehensive response to attaining the voluntary global targets presented in this report.
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This report is one of the first major products of the newly established Precision Public Health Metrics unit of the UCN cluster of the WHO Regional Office for Africa. The report presents national trends in communicable and non-communicable disease burden and control in the WHO African region. It tra...cks progress made with respect to disease burden reduction, elimination and eradication. It also highlights major emerging threats, opportunities and priorities in the fight against commu- nicable and non-communicable diseases in the region. It covers the period 2000-2022, but for some indicators, information is available only up to 2021.
The report shows the number of reported cases for malaria and vaccine preventable diseases (meningitis, measles, yellow fever, pertussis, diphtheria, tetanus, and polio); disease incidence due to HIV, tuberculosis and four major noncommunicable diseases (cardiovas- cular diseases, cancers, diabetes and chronic respira- tory diseases).
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World Health Organization. (2022). Toolkit for developing a multisectoral action plan for noncommunicable diseases: module 4: developing an implementation plan.
To maintain a structured and well-organized implementation plan it is important to have a lead agency or sector. The ministry of health or a similar authority in government will be critical in facilitating development and implementation of the multisectoral action plan.
Malawi is a landlocked country with a surface area of 118,484 km2. Administratively, the country is divided into three regions, namely the Northern, Central and Southern regions. The country has 28 districts, which are further divided into traditional authorities (TA) ruled by chiefs. The TAs are su...b-divided into villages, which form the smallest administrative units. The Village Development Committees (VDCs) under the TAs are responsible for development activities. Politically, each district is divided into constituencies that are represented by Members of Parliament (MPs) in the National Assembly for purposes of legislations. Constituencies are further divided into wards which are represented by a ward councillor at district assembly.
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The document, "Progress on the Prevention and Control of Non-Communicable Diseases," reports on global efforts to reduce the impact of NCDs, such as heart disease, cancer, diabetes, and chronic respiratory diseases, following the commitments made at high-level United Nations meetings. It highlights ...the inadequate progress in meeting the targets set under the Sustainable Development Goal 3.4 to reduce premature NCD mortality by one-third by 2030. Key challenges include insufficient funding, limited implementation of effective interventions, and political and economic barriers, especially in low-income countries. The report calls for strengthened international cooperation, policy reform, and innovative approaches to meet global health targets.
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The Country Cooperation Strategy is the World Health Organization (WHO)’s reference for country work guiding planning and resource allocation through alignment with national health priorities and harmonization with other development partners. It clarifies roles and functions of WHO in supporting t...he national strategic plan for health through the Sector-Wide Approach and Malawi Growth and Development Strategy II. The Country Cooperation Strategy is based on a systematic assessment of the recent national achievements, emerging health needs,
challenges, government policies and expectations. An evaluation of the previous CCS was conducted and jointly discussed with the Ministry of Health as well as other key stakeholders. This process led to the identification of the, achievements, challenges and shortfalls of the previous CCS. Through this process the areas where WHO needed to focus on were also identified. The CCS development has also been done in parallel with the formulation of the new Health Sector Strategic Plan (HSSP) to ensure that there is a linkage between the two.
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Alcohol use is deeply embedded in the social landscape of many societies, and some 2300 million people drink alcoholic beverages in most parts of the world. At the same time, more than half of the global population aged 15 years and older reported having abstained from drinking alcohol during the pr...evious 12 months. Several major factors have an impact on levels and patterns of alcohol consumption in populations – such as historical trends in alcohol consumption, the availability of alcohol, culture, economic status and implemented alcohol control measures. At the individual level the patterns and levels of alcohol consumption are determined by multiple factors that include gender, age and individual biological and socioeconomic vulnerability factors as well as the policy environment. Prevailing social norms that support drinking behaviour and mixed messages about the harms and benefits of drinking may encourage alcohol consumption, delay appropriate health-seeking behaviour and weaken community action.
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Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was... the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
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Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 202...1 to 784 million by 2045.1 As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030.2 Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
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While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challeng...es, including misdiagnosis and access to insulin, can affect T1D outcomes and frequency of severe complications. Despite the severe nature of T1D and growing burden in subSaharan Africa, little is currently known about the impact of T1D on patients and caregivers in the region. Methods We conducted a qualitative study consisting of interviews with patients with T1D, caregivers, providers, civil society members and a policy-maker in Liberia to better understand the psychosocial and economic impact of living with T1D, knowledge of T1D and selfmanagement, and barriers and facilitators for accessing T1D care.
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The Global Action Plan on Antimicrobial Resistance (AMR) calls for making AMR a core component of professional education and training. In 2018, the World Health Organization (WHO) published Competency framework for health workers’ education and training on AMR to ensure that academic institutions ...and regulatory agencies provided pre-service and in-service training to equip health workers with the adequate competencies to address AMR. This was followed by Health workers’ training and education on AMR: curricula guide, which outlines the learning objectives and expected outcomes of pre-service training of health workers to improve curricula. These tools were designed to strengthen the capacity of health workers in various settings to address the growing challenge of AMR.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Objective: To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil.
Metho...ds: A cross-sectional, population-based survey of non-institutionalised adults age 30 or greater was conducted in three municipalities in Eastern Brazil. Data were analysed as survey-weighted percentages of the sampled populations.
Results: 3035 surveys were completed. Overall, one-third of respondents was unable to identify at least one cardiovascular disease risk factor and 25% unable to identify at least one myocardial infarction symptom. A minority of respondents had received training in CPR or were able to identify an AED. Low levels of education and low socioeconomic status were consistent predictors of lower knowledge levels of cardiovascular disease risk factors, acute coronary syndrome symptoms and CPR and AED use.
Conclusions: In three municipalities in Eastern Brazil, overall public knowledge of cardiovascular disease risk factors and symptoms, as well as knowledge of appropriate CPR and AED use was low. Our findings indicate the need for interventions to improve public knowledge and response to acute cardiovascular events in Brazil as a first step towards improving health outcomes in this population. Significant heterogeneity in knowledge seen across sites and socioeconomic strata indicates a need to appropriately target such interventions.
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Hypertension is referred to as a “silent killer”. Most people with hypertension are unaware of their condition as in most cases, they experience no warning signs or symptoms hence they are not identified or treated. Hypertention is associated with a number of conditions, disability, and causes o...f death. These include: strokes; myocardial infarction; end-stage renal disease; congestive heart failure; peripheral vascular disease and blindness. According to Stats SA, in 2017, hypertensive disorders resulted in 19 900 deaths with a further 44 357 deaths associated with cerebrovascular diseases and other heart diseases. This means around 30% of all deaths in 2017 were associated with increased blood pressure.
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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...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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