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6
In Control: A Practical Handbook for Professionals Working in Health Emergencies Internationally RKI
The greatest risk to persons engaging in international medical emergency response is poor preparation.
The In Control handbook hopes to provide a remedy.
At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health emergency that disregards physical borders, brin
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gs into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated.
Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all.
The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world.
The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards.
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This report started with a simple question—“How can we tell how much funding is devoted to global health programs?”—and ended (more than two years later) with an answer that is far from simple. As those who have tried know well, tracking health-related funding is challenging in any setting,
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given the range of public and private sources and the many types of services and programs that fall within the definition of “health sector.” It is made all the more complicated when significant external support from donors and private charities plus in-kind donations of drugs and other inputs are taken into account. The task is made yet harder by inadequate public expenditure management systems in countries where public agencies’ capacity is stretched very thin and by donor accounting structures that are not designed to respond in a timely way
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The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20
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30, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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According to most recent data, the world economy grew by 3.1 per cent in 2022. To many, the rebound
suggested that a soft landing was possible in 2023, and that the key problems of the year 2022 – rising
prices, supply-chain disruptions and recession risks – have been addressed. As a result, t
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he very first
months of 2023 were viewed with optimism by decision-makers, as it appeared that the anti-inflationary
stance of the central banks had set a path to price stabilization without causing a major disruption to
growth.
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Promoting and protecting health is essential to human welfare and sustained economic and social development. This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that Health for All would contribute
both to a better quality of life and also to global peace a
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nd security
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This report analyses the intersection of HIV, COVID-19 and public debt in developing countries. The collision between COVID-19 and a crippling debt crisis have reversed decades of progress - putting present and future investments in health and HIV at risk. Pragmatic options to address the pandemic t
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riad are proposed.
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The urgency of now - Turning the tide against epidemic and pandemic infectious diseases
Coalition for Epidemic Preparedness Innovations (CEPI)
Coalition for Epidemic Preparedness Innovations (CEPI)
(2021)
CC
CEPI is seeking to raise $3.5 billion to implement CEPI’s next 5-year plan. To mitigate the immediate threat of COVID-19 variants, it is activating key elements of this plan now—and seeking to mobilise a portion of this $3.5 billion in 2021. We have already launched R&D programmes to initiate de
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velopment of next-generation vaccines against COVID-19 variants and we are planning studies to answer critical scientific questions related to the durability of immunity, effectiveness of mixed-vaccine regimens, and vaccine effectiveness in vulnerable populations such as pregnant women. We are also bringing forward our plans to develop vaccines that could protect against multiple COVID-19 variants and other coronavirus specie
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Global Vaccine Summit 2020 - Chair’s Summary
Global Alliance for Vaccines and Immunisation (Gavi)
Global Alliance for Vaccines and Immunisation (Gavi)
(2020)
CC
The UK government hosted the Global Vaccine Summit on June 4, 2020 under the patronage of the Rt. Hon. Boris Johnson, Prime Minister of the United Kingdom of Great Britain and Northern Ireland. The meeting was held by videoconference in light of the ongoing COVID-19 pandemic. 2. The Summit brought
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together more than 300 people, including 42 Heads of State and Government. 62 countries were represented, notably 14 Gavi implementing countries, all of the G7 nations and 19 governments of the G20. Eminent participants also included H.E. Antonio Guterres, Secretary-General of the United Nations; H.E. Moussa Faki Mahamat, Chairperson of the African Union Commission; H.E. Dr Tedros Adhanom Ghebreyesus, WHO Director-General; H.E. Henrietta Fore, UNICEF Executive Director; Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation; Ministers from implementing and donor countries; CEOs of vaccine manufacturing companies and private sector partners; leaders of UN and other international agencies; senior civil society representatives; and Gavi champions. A full list of the participants can be found in Annex.
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The development of this draft Proposed programme budget 2022–2023 comes at a unique moment for WHO. The world is in the grip of the coronavirus disease (COVID-19) pandemic and faces health, social and economic consequences on an unprecedented scale. Although it is not known when the COVID-19 pande
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mic will end, recent encouraging vaccine results, in addition to the examples of countries that have achieved good results through public health measures, hold out the prospect of better days ahead. The full impact of the pandemic cannot yet be determined. But whatever its implications, the Secretariat will rise to the challenge and is ready to adapt so that it is fully equipped to support Member States for any eventuality in the future – to make sure that the world will never again have to face this kind of crisis.
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Development finance institutions owned by European governments and the World Bank Group are spending hundreds of millions of dollars on expensive for-profit hospitals in the Global South that block patients from getting care, or bankrupt them, with some even imprisoning patients who cannot afford th
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eir bills. At the height of the COVID-19 pandemic, some of these same hospitals denied entry to patients suffering from the virus or sold intensive care beds at eyewatering prices to the highest bidder. These development institutions have woefully inadequate safeguards, invest via a complex web of tax-avoiding financial intermediaries, and offer little to zero evidence on the impacts their investments are having. Oxfam is calling on rich-country governments and the World Bank Group to immediately halt their spending on for-profit private healthcare, and for an urgent independent investigation to be conducted into all active and historic investments.
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The GFF needs an additional US$2.5 billion from 2021 to 2025 to enable countries to protect health gains and accelerate progress toward the 2030 Goals. Of this amount, the GFF urgently needs to secure new pledges of US$1.2 billion by the end of 2021 to help its current 36 partner countries protect
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and maintain essential health services and implement time-sensitive service delivery and health system improvements to enable a sharp bend of the curve back to a positive trajectory to close the gap to the SDGs.
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It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t
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he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency.
Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls.
An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is:
A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes).
An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa.
The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions.
Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward.
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This report makes clear that there is a path to end AIDS. Taking that path will help ensure preparedness to address other pandemic challenges, and advance progress across the Sustainable Development Goals. The data and real-world examples in the report make it very clear what that path is. It is not
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a mystery. It is a choice. Some leaders are already following the path—and succeeding. It is inspiring to note that Botswana, Eswatini, Rwanda, the United Republic of Tanzania and Zimbabwe have already achieved the 95–95–95 targets, and at least 16 other countries (including eight in sub-Saharan Africa) are close to doing so.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog
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nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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This manual and its Excel tool are under revision. The revised edition will be published soon.
The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The
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Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex.
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La carga de la diabetes es enorme, posicionándola como uno de los principales desafíos que enfrenta la salud pública en la actualidad. Actualmente, se estima que 62 millones de personas viven con diabetes en la Región de las Américas y las proyecciones muestran que su prevalencia seguirá aumen
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tando en los próximos años. La Región muestra el mayor número de años de vida saludable perdidos (ya sea por discapacidad o muerte prematura) debido a la diabetes en todo el mundo. Los altos costes asociados a su tratamiento producen una pesada carga económica. Sus complicaciones pueden afectar seriamente la calidad de vida de las personas que viven con diabetes, sus familias y la sociedad y sobrecargar los sistemas de salud. Este informe muestra los últimos datos comparables internacionalmente sobre la diabetes y sus principales factores de riesgo por año, país y sexo. También incluye un resumen de la respuesta de los sistemas de salud de los países a la diabetes, incluidos planes nacionales, objetivos, vigilancia, directrices y acceso a medicamentos y tecnologías esenciales, y sintetiza información sobre las complicaciones relacionadas con la diabetes y la estrecha relación entre la diabetes y otras patologías, como enfermedades cardiovasculares, tuberculosis y COVID-19.
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There is growing understanding and high-level endorsement of the importance of strong collaborative multisectoral approaches to address a broad range of social, economic and governance issues for the prevention and control of noncommunicable disease (NCDs) and mental health conditions. In 2019, Worl
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d Health Organization (WHO) Member States requested the WHO Director-General to provide an analysis across countries of successful approaches for the prevention and control of NCDs that used multisectoral action.This report describes the experiences of different countries, areas and territories in implementing multisectoral actions to tackle NCDs and is the first step to address their request for an analysis of such efforts
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This report compiles data for the first time on the far-reaching consequences of uncontrolled hypertension, including heart attacks, strokes and premature death, along with substantial economic losses for communities and countries. It also contains information on the global, regional and country-lev
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el burden of hypertension and progress of control efforts.
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Trustworthy, evidence-based health guidelines form the basis of national policies affecting both patients and health-care workers. Emphasizing the link between robust evidence and people’s trust in their health systems, Dr Hans Henri P. Kluge, WHO Regional Director for Europe said at the launch ev
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ent, “Trust and transformation are key words for us, especially when we talk about improving and strengthening our health systems. Transformation should first and foremost serve the interests of patients and health-care workers”.
While it is not always easy to demonstrate the immediate effect of guidelines on people’s health, there is no viable alternative to utilizing guidelines based on the best available evidence.
Yet, developing robust guidelines remains a challenge for most countries. “Guidelines need to be both simple to use and timely, they need to address people’s real needs, especially at the local level, and should ultimately reflect the resources available,” said Dr Natasha Azzopardi-Muscat, Director, Country Health Policies and Systems, WHO/Europe. “This means that any successful guideline needs to be adjusted and adapted to local contexts and realities.”
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