In the last decade, Timor-Leste has made remarkable progress in strengthening its health system and improving the health status of its population. This has resulted in an increased life expectancy, and the achievement of Millennium Development Goals such as a reduction in infant and under-five morta...lity, an improvement in maternal and child health outcomes, and an increase in immunization coverage. Further, the country has successfully eliminated infectious diseases such as polio, measles, and maternal and neonatal tetanus. There is full political commitment to reducing the incidence of tuberculosis (TB) by 80% and the number of deaths due to TB by 90% by 2030. The country has made great progress in the context of the pandemic, having established numerous quarantine facilities/isolation centres; trained health-care workers; streamlined the procurement and supply of medicines, consumables, personal protective equipment and other equipment; and strengthened the capacity in critical care across secondary and tertiary health care, to better respond to future pandemics and other disaster situations.
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The WHO Pharmaceuticals Newsletter provides you with the latest information on the safety of medicinal products and regulatory actions taken by authorities around the world.
In addition, this edition includes summary and recommendations from the virtual meeting of the members of the WHO Programme f...or International Drug Monitoring (PIDM) and other partners, which was held on 20 October 2022.
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Frequently Asked Questions on Visceral Leishmaniasis
The conditionality of this recommendation is largely driven by the current higher unit cost of pyrethroid-PBO ITNs compared
to pyrethroid-only LLINs and therefore the uncertainty of their cost-effectiveness. Furthermore, as PBO is less wash-resistant
than pyrethroids, its bioavailability declines ...faster over the three-year estimated life of an ITN; therefore, the added impact of
pyrethroid-PBO ITNs over that of pyrethroid-only LLINs may decline over time. The evidence comes from two sites in
eastern Africa with pyrethroid resistance and not from other geographies where transmission levels and vector characteristics
may vary. PBO acts by inhibiting certain metabolic enzymes, primarily oxidases, and so are likely to provide greater protection
than pyrethroid-only LLINs where mosquitoes display mono-oxygenase-based insecticide resistance mechanisms.
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Since 24 February 2022, the war in Ukraine has caused widespread suffering to its people and serious damage
to the country’s infrastructure. Attacks on the country’s health system and its power network threaten people, compromise the provision of health care, and complicate the distribution of ...essential medicines and equipment.
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Rabies has an enormous impact on both agriculture and conservation biology, but its greatest burden is undeniably on public health. As such, routine methods for rapid risk assessment after human exposures to rabies as well as applications for laboratory-based surveillance, production of biologicals ...and management of this infectious disease are critical. Given its mandate to improve human health and control disease among its Member States, WHO has led the production of this fifth edition of Laboratory techniques in rabies.
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Avec l’essor des traitements antirétroviraux (TAR) à base de dolutégravir (DTG) pour soigner les personnes vivant avec
le VIH dans le monde, il est important d’estimer la vitesse à laquelle la résistance acquise au DTG apparaît dans les
populations sous TAR. Bien que la résistance au DT...G ne soit pas apparue dans les populations naïves aux TAR incapables
de supprimer la charge virale dans les essais cliniques, certains éléments portent à croire que la résistance au
DTG peut émerger chez les personnes suivant des schémas thérapeutiques incluant le DTG. L’OMS recommande aux
pays qui étendent les TAR incluant le DTG d’accompagner ce déploiement d’une surveillance en routine de la pharmacorésistance
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A medida que el tratamiento antirretrovírico con dolutegravir se extiende a más personas que viven con el VIH en el
mundo, adquiere más importancia estimar la frecuencia con que surge la farmacorresistencia adquirida a este
antirretrovírico en las poblaciones tratadas con esquemas que lo conti...enen. Si bien no se ha detectado resistencia
al dolutegravir en los ensayos clínicos con poblaciones no tratadas antes con antirretrovíricos en las que se ha
detectado una viremia persistente pese al tratamiento, los datos indican que puede surgir en quienes toman esquemas
con dolutegravir. La OMS recomienda a los países que estén ampliando el tratamiento con dolutegravir que acompañen
su despliegue con la vigilancia sistemática de la farmacorresistencia.
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In the context of limited resources, national malaria programmes may need to decide on how to prioritize all WHO-recommended interventions . This guidance document has been developed to support national malaria programmes in prioritization decisions, specifically on the deployment scope and product ...choice of insecticide-treated nets (ITNs). This guidance is to be
followed when programmes do not have sufficient budget to deploy the most effective ITNs to all populations at risk.
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The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by countries and health sys...tems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
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Physical activity plays an important role in the care of people living type 2 diabetes. Regular physical
activity can help reduce some of the harmful effects and slow or even reverse disease progression.
Being active can also reduce symptoms of depression and anxiety, and enhance thinking, learnin...g, and
overall well-being. Conversely, too much sedentary behaviour can be unhealthy.
Everyone can benefit from increasing physical activity and reducing sedentary behaviour. However, many
people face barriers or may be concerned about becoming more active. Additional guidance and support
can help people living with type 2 diabetes be more active for their health and well-being.
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Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic
retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report...ed to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources.
Epidemiological studies and clinical trials have shown that optimal control of blood glucose, blood pressure, and blood lipids can reduce the risk of developing retinopathy and slow its progression. Timely treatment with laser photocoagulation, and increasingly, the appropriate use of intraocular administration of vascular endothelial growth factor (VEGF) inhibitors can prevent visual loss in vision- threatening retinopathy, particularly diabetic macular edema (DME). Since visual loss may not be present in the earlier stages of retinopathy, regular screening of persons with diabetes is essential to enable early intervention.
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Glaucoma is a leading cause of irreversible blindness globally. In Malawi, glaucoma accounts for 15.8% of the blindness among people aged 50 years and above. Blindness from glaucoma is preventable with early detection and timely treatment. However, glaucoma management remains a challenge to eye care... providers due to its asymptomatic progression.
These guidelines inform eye care providers about the requirements for early detection of glaucoma, and the appropriate assessment and management of glaucoma patients. The guidelines also demonstrate the need for ophthalmologists to work with secondary-level eye care providers. With
glaucoma being a permanently blinding condition, it is vital to ensure that all eye care providers are adequately equipped with skills and resources for the early detection and management of glaucoma.
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Report of a global meeting on yaws eradication surveillance, monitoring and evaluation: Geneva, 29–30 January 2018. World Health Organization.
Training in monitoring and epidemiological assessment of mass drug administration for eliminating lymphatic filariasis: learners’ guide. World Health Organization.
During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc...e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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The Fifty-first World Health Assembly adopted resolution WHA51.11 in 1998, which targets the
global elimination of trachoma as a public health problem by 2020 (1). The strategy recommended
to achieve that goal is encapsulated by the acronym “SAFE”, which represents: Surgery for
individuals wi...th trachomatous trichiasis (TT; the late blinding stage of trachoma); and Antibiotics,
Facial cleanliness and Environmental improvement (2). The A, F and E interventions are delivered to
entire districts in which active (inflammatory) trachoma is common in order to treat ocular infection
with Chlamydia trachomatis, the causative organism of trachoma, and sustainably reduce its
transmission.
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The Operational guide: use of referral laboratories for the analysis of foodborne hazards in the Pacific aims to strengthen the food analysis capacity of Pacific Island countries and areas by identifying national and reference laboratories capable of testing for priority foodborne hazards. The Pacif...ic Island countries and areas are often vulnerable to food safety incidents and emergencies due to their geographical distribution and dependence on food imports. The guide outlines key considerations for selecting referral laboratories and submitting samples to them, enabling continuous improvement of food safety systems and providing safe food for all. The target audiences are health and food safety authorities.
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This volume contains monographs prepared at the ninety-first meeting of the Joint FAO/WHO Expert Committee on Food Additives (JECFA), which met virtually online from 1 to 12 February 2021.
The detailed monographs in this volume summarize data on specific contaminants in food. Individual monographs ...present the assessment of exposure to cadmium from all food sources, the technical, analytical, dietary exposure and toxicological data on ergot alkaloids, an assessment of five substances that may occur as previous cargoes, and a revision of the specifications for steviol glycosides. This volume and others in the WHO Food Additives series contain information that is useful to those who produce and use food additives and veterinary drugs and those involved with controlling contaminants in food, government and food regulatory officers, industrial testing laboratories, toxicological laboratories and universities.
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HIV, viral hepatitis and STI epidemics, particularly among people who inject drugs and other key populations, continue to be fuelled by laws and policies criminalizing sex work; drug use or possession; diverse forms of gender expression and sexuality; stigma and discrimination; gender discrimination...; violence; lack of community empowerment and other violations of human rights. These sociostructural factors limit access to health services, constrain how these services are
delivered and diminish their effectiveness.
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