These consolidated guidelines on HIV testing services (HTS) bring together existing and new guidance on HTS across different settings and populations.
The World Health Organization (WHO) first released consolidated guidelines on HTS in 2015, in response to requests from Member States, national pr...ogramme managers and health workers for support to achieve the United Nations (UN) 90–90–90 global HIV targets – and specifically the first target of diagnosing 90% of all people with HIV. In 2016, based on new evidence, WHO released a supplement to address important new HIV testing approaches – HIV self-testing (HIVST) and provider-assisted referral.
Since the release of 2015 and 2016 HTS guidelines, new issues and more evidence have emerged. To address this, WHO has updated guidance on HIV testing services. In this guideline, WHO updates recommendation on HIVST and provides new recommendations on social network-based HIV testing approaches and western blotting (see box, next page). This guideline seeks to provide support to Member States, programme managers, health workers and other stakeholders seeking to achieve national and international goals to end the HIV epidemic as a public health threat by 2030.
These guidelines also provide operational guidance on HTS demand creation and messaging; implementation considerations for priority populations; HIV testing strategies for diagnosis HIV; optimizing the use of dual HIV/syphilis rapid diagnostic tests; and considerations for strategic planning and rationalizing resources such as optimal time points for maternal retesting
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Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.... These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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Around the world, millions of refugees and migrants in vulnerable situations, such as low-skilled migrant workers, face poorer health outcomes than their host communities, especially where living and working conditions are sub-standard, according to the first WHO World report on the health of refuge...es and migrants. This has dire consequences for the probability that the world will not achieve the health-related Sustainable Development Goals for these populations.
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An estimated 1.3 billion people – or 16% of global population worldwide – experience a significant disability today. Persons with disabilities have the right to the highest attainable standard of health as those without disabilities. However, the WHO Global report on health equity for persons w...ith disabilities demonstrates that while some progress has been made in recent years, the world is still far from realizing this right for many persons with disabilities who continue to die earlier, have poorer health, and experience more limitations in everyday functioning than others. These poor health outcomes are due to unfair conditions faced by persons with disabilities in all facets of life, including in the health system itself. Countries have an obligation under international human rights law to address the health inequities faced by persons with disabilities. Furthermore, the Sustainable Development Goals and global health priorities will not progress without ensuring health for all.
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This draft Roadmap for the Global Health for Peace Initiative has been developed in response to decision WHA75(24) of the 75th World Health Assembly (2022), which requested that WHO develop, in full consultation with Member States and Observers, and in full collaboration with other organizations of ...the United Nations system and relevant non-State actors in official relations with WHO, a Roadmap, if any, for the Global Health and Peace Initiative.
It incorporates feedback received from Member States through a first round of consultation carried out at the end of 2022. This (second) draft is being made available ahead of the 152nd session of the Executive Board, that will consider the draft Roadmap.
The Roadmap for the Global Health for Peace Initiative aims to provide a framework for the Initiative at global level, defining concepts, establishing principles, setting strategic goals and objectives as well as operational priorities. It also describes the “Health for Peace approach” to programming, which lies at the core of the Global Health for Peace Initiative (GHPI). The GHPI is a global initiative of WHO that aims to enhance the existing links between health (and health interventions) and peace
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In their 2015 declaration "Transforming our world: the 2030 Agenda for Sustainable Development", Member States pledged to end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases by 2030, and to combat hepatitis and other communicable diseases. This report reviews progress an...d challenges in the global response to reduce the burden of these diseases in the context of the Millennium Development Goals, and looks ahead to identify the strategies and approaches that will be needed to accelerate progress during the new development era. The report was developed by WHO's Cluster for HIV/AIDS, TB, Malaria and Neglected Tropical Diseases in 2015.
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The control and elimination of schistosomiasis have over the last two decades involved several strategies, with the current strategy by the World Health Organization (WHO) focusing mainly on treatment with praziquantel during mass drug administration (MDA). However, the disease context is complex wi...th an interplay of social, economic, political, and cultural factors that may affect achieving the goals of the Neglected Tropical Disease (NTD) 2021-2030 Roadmap. There is a need to revisit the current top-down and reactive approach to schistosomiasis control among sub-Saharan African countries and advocate for a dynamic and diversified approach.
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Background: The human helminth infections include ascariasis, trichuriasis, hookworm infections, schistosomiasis, lymphatic filariasis (LF) and onchocerciasis. It is estimated that almost 2 billion people worldwide are infected with helminths. Whilst the WHO treatment guidelines for helminth infecti...ons are mostly aimed at controlling morbidity, there has been a recent shift with some countries moving towards goals of disease elimination through mass drug administration, especially for LF and onchocerciasis. However, as prevalence is driven lower, treating entire populations may no longer be the most efficient or cost-effective strategy. Instead, it may be beneficial to identify individuals or demographic groups who are persistently infected, often termed as being “predisposed” to infection, and target treatment at them.
Methods: The authors searched Embase, MEDLINE, Global Health, and Web of Science for all English language, humanbased papers investigating predisposition to helminth infections published up to October 31st, 2017. The varying definitions used to describe predisposition, and the statistical tests used to determine its presence, are summarised. Evidence for predisposition is presented, stratified by helminth species, and risk factors for predisposition to infection are identified and discussed.
Results: In total, 43 papers were identified, summarising results from 34 different studies in 23 countries. Consistent evidence of predisposition to infection with certain species of human helminth was identified. Children were regularly found to experience greater predisposition to Ascaris lumbricoides, Schistosoma mansoni and S. haematobium than adults. Females were found to be more predisposed to A. lumbricoides infection than were males. Household clustering of infection was identified for A. lumbricoides, T. trichiura and S. japonicum. Ascaris lumbricoides and T. trichiura also showed evidence of familial predisposition. Whilst strong evidence for predisposition to hookworm infection was identified, findings with regards to which groups were affected were considerably more varied than for other helminth species.
Conclusion: This review has found consistent evidence of predisposition to heavy (and light) infection for certain human helminth species. However, further research is needed to identify reasons for the reported differences between demographic groups. Molecular epidemiological methods associated with whole genome sequencing to determine ‘who infects whom’ may shed more light on the factors generating predisposition.
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Investing to overcome the global impact of neglected tropical diseases charts new ground in tackling the 17 neglected tropical diseases (NTDs) that aff ect more than a billion people in 149 countries worldwide. It makes the case for domestic investment to reach the targets of WHO’s Roadmap on NTDs... by 2020 and sustain enhanced, equitable access to high-quality coverage against these diseases to 2030.
Th is third WHO report anticipates the investments needed as countries graduate from
low-income to middle-income status and as the world’s focus expands from the Millennium Development Goals to the Sustainable Development Goals.
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This publication articulates the WHO Botswana Country Office’s focus and investment needs for the biennium 2022–2023, building on achievements, networks, and partnerships fostered in 2020-2021.
As the leading health authority within the United Nations system in Botswana, the WHO Country Offi...ce has been at the forefront of supporting the government to improve health since 1996. The WHO Country Office supports the Ministry of Health in realizing the health goals the Government of Botswana defines. Acknowledging that as an upper middle-income country, Botswana provides the bulk of its resources for implementing health programmes, the WHO directly brings technical expertise to the table by collaborating with relevant partners. Where the country office has limitations in terms of human resources with the requisite expertise to answer the country’s needs, the regional level and headquarters of the WHO will be mobilized to provide the necessary support.
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We created a dataset to generate estimates of donor-reported ‘official development assistance’ and private grants (ODA+) to reproductive, maternal, newborn and child health (RMNCH) by donor, recipient country and activity type over the period 2003–2013. We collected disbursement information fr...om the Organisation for Economic Co-operation and Development Creditor Reporting System (CRS) in January 2015. All 2.1 million records across all sectors were coded based on donor name, project title, short and long descriptions, and CRS code describing the purpose of the disbursement. We classified records according to the degree to which they would promote attainment of Millennium Development Goals 4 and 5 (reproductive and sexual health, maternal and newborn health, and child health). We also classified records according to whether they supported prenatal and neonatal health (PNH). The dataset includes project funding as well as allocating shares of general budget support, health sector support and basket funding. The data can be used to analyse resource flows to RMNCH or to other purposes or beneficiaries of ODA+.
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The International Conference on Population and Development in 1994 set targets for donor funding to support family planning programmes, and recent initiatives such as FP2020 have renewed focus on the need for adequate funding to rights-based family planning. Disbursements supporting family planning ...disaggregated by donor, recipient country and year are not available for recent years. We estimate international donor funding for family planning in 2003–13, the period covering the introduction of reproductive health targets to the Millennium Development Goals and up to the beginning of FP2020, and compare funding to unmet need for family planning in recipient countries. We used the dataset of donor disbursements to support reproductive, maternal, newborn and child health developed by the Countdown to 2015 based on the Organization for Economic Cooperation and Development Creditor Reporting System.
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This ACTIVE toolkit provides evidence-based guidance on the key approaches to promote and enable older people to be physically active, regardless of who they are, where they live, or their intrinsic capacities (for example their visual or cognitive abilities) or whether they live with chronic condit...ions (for example, diabetes, hypertension, and arthritis). It is designed to support all countries at national and subnational levels (particularly low- and middle-income countries with limited resources) to ensure that environments and settings support older people to be active, and that they provide physical activity services and programmes tailored to the needs, preferences and goals of all older people.
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This strategy was developed to further support countries in their efforts to strengthen their capacity to implement key interventions to optimize their RHIS, enabling the monitoring and delivery of Health Care Services, especially Primary Health Care (PHC). The strategy proposes principles for integ...rated, interoperable, evidence-informed, aligned and partnership-based RHIS through five strategic goals with measurable interventions.
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The purpose of this workbook is to assist ministries of health, health managers and practitioners in engaging with the private sector on delivery of quality maternal, newborn and child health (MNCH) services in lower- and middle-income countries. Private health care is one of the fastest growing seg...ments of the health-care system in lower- and middle-income countries, and private providers are an important source of health care. To accelerate progress to reach the Sustainable Development Goals for ending preventable maternal, newborn and child deaths, it is critical that whole health system organizations invest not only in increasing coverage of interventions, but also in quality. The audience for the workbook is those who are involved with organizing and implementing processes for engaging the private sector in delivery of quality MNCH services.
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Animicrobial resistance (AMR) was declared by the World Health Organization (WHO) as one of the
top 10 health threats facing humanity. The effects of AMR are far-reaching as it cuts across sectors and affects food safety,
nutrition security, livelihoods, environment and, consequently, attainment o...f several sustainable development goals (SDGs)
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The Global status report on alcohol and health and treatment of substance use disorders presents a comprehensive overview of alcohol consumption, alcohol-related harm and policy responses as well as treatment capacities for alcohol and drug use disorders worldwide. The report is based on data collec...ted by WHO from Member States and organized in accordance with the Sustainable Development Goals health target 3.5 which calls on countries to strengthen “the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol”. The chapter on alcohol and health continues the series of WHO global status reports on alcohol and health and presents the latest available data on the status of, and trends in, alcohol consumption, as well as estimates of the alcohol-attributable disease burden and descriptions of policy responses worldwide. On the basis of data collected from countries on the treatment of substance use disorders the report describes the status of key components of treatment responses to alcohol and drug use disorders and proposes a new service capacity index for these disorders as an additional contextual indicator for monitoring progress in this domain of SDG health target 3.5. The report concludes with broad directions for international action to accelerate progress towards achievement of SDG health target 3.5.
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The Global Leprosy Strategy 2021–2030 “Towards zero leprosy” was developed through a broad consultative process with all major stakeholders during 2019 and 2020. Valuable inputs were provided by national leprosy programme managers, technical agencies, public health and leprosy experts, funding... agencies and persons or members of communities directly affected by leprosy.
The Strategy aims to contribute to achieving the Sustainable Development Goals. It is structured along four pillars:
(i) implement integrated, country-owned zero leprosy road maps in all endemic countries;
(ii) scale up leprosy prevention alongside integrated active case detection;
(iii) manage leprosy and its complications and prevent new disability; and
(iv) combat stigma and ensure human rights are respected. Interruption of transmission and elimination of disease are at the core of the Strategy.
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