In the early morning of 6 February 2023, a magnitude 7.8 earthquake struck southern Türkiye near the northern
border of Syria. The earthquake was followed 11 minutes later by a magnitude 6.7 aftershock. Many aftershocks
continue to be felt across the region. Whilst the impact is still being ass...essed, initial reports evidence significant
damage in the areas of southern Türkiye and northern Syria.
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In the early morning of 6 February 2023, a magnitude 7.8 earthquake occurred in southern Türkiye near the
northern border of Syria. The earthquake was followed 11 minutes later by a magnitude 6.7 aftershock. Many
aftershocks are still being felt across the region. Whilst the impact is still bei...ng assessed, initial reports evidence
significant damage in the areas of southern Türkiye and northern Syria.
In response, the Syria Ministry of Health (MoH) activated its emergency operations centre (EOC) on 6 Feb 2023
under the chairmanship of the Deputy Minister. In all affected governorates, public and private health facilities
and medical convoys have been repurposed to support the response and are being managed by the National
Ministry of Health (MoH) and Directorate of Health (DoH) at governorate level. Support has been directed to
affected areas, with medical convoys including 28 ambulances and 7 mobile clinics, deployed from the health
directorates of Damascus, Rural Damascus, Quneitra, Homs, Tartous, Aleppo and Latakia
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Despite a historical association with poor tolerability, a comprehensive review on safety of antileishmanial chemotherapies is lacking. We carried out an update of a previous systematic review of all published clinical trials in visceral leishmaniasis (VL) from 1980 to 2019 to document any reported ...serious adverse events (SAEs).
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Lateral-flow rapid diagnostic tests (RDTs) continue to play a vital role in global health in the management and diagnosis of infectious diseases, including malaria, HIV and COVID-19. Visually interpreted RDTs, more than any other class of diagnostics, fulfil WHO’s ASSURED criteria,1 enabling their... use at the lowest levels of health care and in self-testing.2 Their utility is, however, compromised every time a test is incorrectly performed or interpreted or its result is not available in a timely manner for clinical decisionmaking and surveillance.
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Sexual exploitation, sexual abuse and sexual harassment (SEAH) violate the rights and wellbeing of the people we serve and the people with whom we serve. Such behaviours are directly in opposition to WHO’s values and our abiding responsibility to do no harm. WHO uses the umbrella term “sexual mi...sconduct” to encompass the full spectrum of prohibited and unwanted behaviour of a sexual nature (including rape and sexual assault) as described in WHO’s 2023 Policy for preventing and addressing sexual misconduct (1). This is because all such acts are prohibited – whether perpetrated by WHO’s own personnel or by implementing partners – and therefore constitute misconduct. The term sexual misconduct is also easier to communicate and translate, as
victims and survivors do not always understand the complicated acronyms and definitions used by the United Nations (UN) and the humanitarian sector. However, we use the terms sexual misconduct and SEAH interchangeably as required when we interact with UN and other stakeholders.
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Snakebite envenoming is a potentially life-threatening disease that typically results from the injection of a mixture of different toxins (“venom”) following the bite of a venomous snake. Envenoming can also be caused by venom being sprayed into a person’s eyes by certain species of snakes tha...t have the ability to spit venom as a defence measure. Not all snakebites result in envenoming: some snakes are non-venomous and venomous snakes do not always inject venom during a bite. About 50–55% of all snakebites result in envenoming. Snake venoms are complex mixtures of protein and peptide toxins, varying from one species to another, and even within species. The toxins in snake venoms are evolutionarily adapted to interact with a large variety of cellular targets in the organisms exposed to them. In humans and animals, snakebite envenoming affects multiple organ systems (depending on the particular species of snake and the classes of toxins present in the venom) and can cause, among other things: haemorrhage and prolonged disruption of haemostasis, neuromuscular paralysis, tissue necrosis, myolysis (muscle degeneration), cardiotoxicity, acute kidney injury, thrombosis and hypovolaemic shock.
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Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe, cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally kn...own as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
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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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Rabies is a fatal viral zoonosis and serious public health problem.1 All mammals are believed to be susceptible to the disease, and for the purposes of this document, use of the term animal refers to mammals. The disease is an acute, progressive encephalitis caused by viruses in the genus Lyssavirus....
2 Rabies virus is the most important lyssavirus globally. In the
United States, multiple rabies virus variants are maintained in wild mammalian reservoir populations such as raccoons, skunks, foxes, and bats. Although the United States has been declared free from transmission of canine rabies virus variants, there is always a risk of reintroduction of these variants.The rabies virus is usually transmitted from animal to animal through bites. The incubation period is
highly variable. In domestic animals, it is generally 3 to 12 weeks, but can range from several days to months, exceeding 6 months.8 Rabies is communicable during the period of salivary shedding of rabies virus. Experimental and historic evidence documents that dogs, cats, and ferrets shed the virus for a few days prior to the onset of clinical signs and during illness. Clinical signs of rabies are variable and include inappetance, dysphagia, cranial nerve deficits, abnormal behavior, ataxia, paralysis, altered vocalization, and seizures. Progression to death is rapid. There are currently no known effective rabies antiviral drugs.
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Rabies is a disease of animals but too often the outcome is gauged in terms of human suffering and
death. Despite this, in areas of the world where rabies is endemic there is often a lack of communication between veterinary and medical professionals, to the extent that the disease continues to thri...ve and potential victims are not treated. The problem is partly
exacerbated by a lack of awareness and experience of the disease and of what to do when confronted by suspect cases. In these technologically advanced days, although it is possible to learn “all there is to know” about almost any subject, it is sometimes difficult to distil the essence.
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Neglected tropical diseases tend to cluster in the same poor populations, and to make progress with their control, they will have to be dealt with in an integrated manner. Peptide microarrays may be a solution to tese problems, where diagnosis for co-infection can be detected simultaneously using th...e one tool.
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A study set out to investigate the factors affecting the prevalence of the practice among cross-border communities in East Africa and the Horn of Africa and the extent to which people cross borders to practise or undergo FGM and the effects of the practice on the women and girls in those communities.... Changes were found in social norms in the cross-border communities investigated, indicating that the practice of female genital mutilation (FGM) can be eradicated. Effective interventions to end FGM need to be tailored to communities’ belief systems if they are to be “owned” by and mobilize the communities to change their culture. This report summarises the findings.
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Since the beginning of the Ukraine crisis on 24 February 2022, WHO has supported Government-led efforts and initiatives alongside key partners on the ground. Building on efforts to date, and working alongside Bulgaria’s health authorities to bring added value to existing mechanisms, the WHO Countr...y Office Bulgaria, the WHO Regional Office for Europe and the WHO Health and Migration Programme, in close collaboration with the Ministry of Health of Bulgaria and key partners, undertook a joint review mission to support Bulgaria, with a focus on addressing the health system needs of refugees, migrants, asylum seekers and vulnerable host populations in Bulgaria.
The assessment team developed this report on the key findings and a package of potential interventions based on the opportunities identified and the need for technical support and assistance. The report summarizes concrete areas of work for which collaborations can be further strengthened. The joint review team identified key recommendations for consideration across 8 priority areas. The report and the outcomes of the review mission serve as a basis for future technical collaboration in the area of refugee health, to address the health needs of refugees and third-country nationals fleeing from Ukraine.
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Violence against women and girls is widespread in the Region of the Americas, resulting in enormous consequences for the health and wellbeing of women and girls, their families and communities. These costs are unacceptable and they can be prevented through evidence-based action, including the health... sector through its policies and protocols, as well as in collaboration with other sectors. This report remains the first of its kind and is a major milestone for the Region. It is specifically informed by the commitments of Member States in the regional Strategy and Plan of Action on Strengthening the Health System to Address Violence against Women. The report provides an analysis of efforts to advance the prevention of violence against women through health policies, clinical protocols, multisectoral plans and related approaches across the Americas. Attention to this topic is timely, as the COVID-19 pandemic has created new visibility for this area of work. This report offers critical information on efforts in the Region that can be learned from and used to build upon in the future to prevent and respond to violence against all women and girls everywhere.
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La violencia contra las mujeres y las niñas es generalizada en la Región de las Américas, y tiene enormes consecuencias para su salud y bienestar, así como el de sus familias y sus comunidades. Se trata de un costo inaceptable que puede ser prevenido mediante acciones basadas en la evidencia, pr...omovidas por las políticas y los protocolos del sector de la salud, y la colaboración con otros sectores. El presente informe es el primero de su tipo y representa un hito importante para la Región. Se basa específicamente en los compromisos asumidos por los Estados Miembros en la Estrategia y plan de acción sobre el fortalecimiento del sistema de salud para abordar la violencia contra la mujer. El informe ofrece un análisis de los esfuerzos para avanzar en la prevención de la violencia contra las mujeres en la Región por medio de políticas de salud, protocolos clínicos, planes multisectoriales y otros enfoques relevantes. La atención a este tema es oportuna, ya que la pandemia de COVID-19 ha dado más visibilidad a esta esfera de trabajo. En este informe se ofrece información crucial sobre los esfuerzos llevados a cabo en la Región, de los cuales se puede aprender y utilizar el conocimiento extraído en el futuro para prevenir y responder a la violencia contra las mujeres y las niñas en todo el mundo.
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Rabies remains an under-reported neglected zoonosis with a case-fatality rate of almost 100% in humans and animals. Dog-mediated human rabies causes tens of thousands of human deaths annually despite being 100% preventable. More than 95% of human cases are caused by the bite of a rabies-infected dog.... Dog-mediated human rabies disproportionately affects rural communities, particularly children, and economically disadvantaged areas of Africa and Asia, where awareness of the disease and access to appropriate post-exposure prophylaxis (PEP) can be limited or nonexistent.
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Chagas disease is currently endemic and also predicted to be at increased transmission risk under future climate change scenarios. Similarly, an expansion of areas in the United States at increased risk for Chagas disease transmission is also expected over the next several decades under climate chan...ge scenarios. Of particular interest is the predicted northern shift of triatomine species to central regions of the United States with historically unsuitable climates for T. cruzi vectors. The weight of evidence regarding the influences climate change may pose on T. cruzi vector species distributions demonstrates the sensitivity of Chagas disease transmission to future climate variability. In order to advance forecasts for the impact climate change may have on Chagas disease transmission in the Americas, it is imperative to
further develop, utilize, and perhaps combine predictive species distribution modeling approaches that integrate accurate, long term data on climate variables, vector species distributions, Chagas disease incidence, as well as other socio-ecological variables.
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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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The military offensive by the Russian Federation in Ukraine which began February 2022 has triggered one of the world’s fastest-growing displacement and humanitarian crisis, with geopolitical and economic ripples felt across the globe. The ongoing war has caused large-scale disruptions to the deliv...ery of health services and a near-collapse of the health system. But the crisis also saw an extraordinary mobilization and crisis response to a health emergency by WHO and its more than 100 partners.
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This bulletin focuses on the situation in Ukraine and several key refugee-receiving countries (Bulgaria, Czechia, Hungary, Poland, Republic of Moldova, Romania, and Slovakia), with the understanding that other countries in the European Region are also receiving Ukrainian refugees and WHO is pr...oviding technical support to them.
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