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On February 29, 2020, the United States and the Taliban signed an agreement outlining a phased withdrawal of US forces from Afghanistan in exchange for Taliban commitments not to allow attacks on the US or its allies from Afghan territory. The troop withdrawal is expected to take place in parallel w
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ith negotiations between representatives from the Afghan government and other Afghan political groups and Taliban leaders aimed at achieving a political settlement after decades of armed conflict.
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Since the launch of the 2012–2020 World Health Organization (WHO) road map for the control, elim-ination and eradication of neglected tropical diseases (NTDs) (1), considerable progress against NTDs has been made. Between 2010 and 2020, the number of people requiring interventions against NTDs glo
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bally fell by 600 million, and 42 countries, areas and territories eliminated at least one NTD (2). In January 2021, a new NTD road map for 2021–2030 (2) was launched, setting future targets and mile-stones for 20 diseases and disease groups. The road map also sets cross-cutting targets, including for strengthened capacity of national health systems to deliver interventions through existing infrastructure.
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BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3026 (Published 11 August 2020)
The BMJ "practice pointer" inlcudes a one-page visual summary of assessment and initial management of patients with persistant symptoms following acute SARS-CoV-2 infection
The framework sets out a response to current mental health challenges arising from the negative impact that the COVID-19 pandemic has had on population mental health and well-being. The EFAMH provides a coherent basis for intensified efforts to mainstream, promote and safeguard mental well-being as
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an integral element of COVID-19 response and recovery; to counter the stigma and discrimination associated with mental health conditions;
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Cada año, más de 700.000 personas pierden la vida por suicidio, la cuarta causa principal de mortalidad entre las personas de 15 a 29 años y la tercera entre las niñas de 15 a 19 años. La reducción de la tasa mundial de mortalidad por suicidio en un tercio para el 2030 es un indicador de los O
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bjetivos de Desarrollo Sostenible de las Naciones Unidas, pero el mundo no está bien encaminado para lograr las metas mundiales y muchas más personas perderán la vida por una causa evitable. La OMS ha elaborado esta guía a fin de apoyar a los países para que ejecuten intervenciones eficaces clave basadas en la evidencia usando como punto de partida el enfoque multisectorial VIVIR LA VIDA, que les permitirá establecer una respuesta nacional integral para prevenir el suicidio.
Excecutive Summary available in English, French, Arabic, Chinese, Russian and Spanisch here:
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Journal of Clinical TB and other Mycobacterial Diseases
uberculosis (TB) in the gastrointestinal tract or peritoneum is an uncommon condition in clinical practice. Its rarity, combined with its nonspecific presentations, makes this kind of extrapulmonary tuberculosis difficult to diagnose as it can
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mimic other inflammatory or malignant conditions. Delays in treatment and frequent misdiagnosis can lead to hazardous complications. In countries like Ecuador where the disease is endemic, TB should always be considered in the differential diagnosis of a patients who present with nonspecific abdominal symptoms. In these scenarios, laparoscopy can be an invaluable tool when used with sufficiently high clinical awareness and adequate training.
Case presentation
We present the case of a 37-year-old female patient from Ecuador with a 1-year history of abdominal pain, nausea, intermittent vomits, night sweats, and weight loss. After clinical evaluation and a laparoscopic intervention, abdominal TB was detected and promptly treated. Antituberculosis chemotherapy was initiated, and the patient successfully reco
High clinical awareness is imperative when approaching abdominal TB due to its wide spectrum of clinical symptoms and its rarity. Early detection and prompt treatment are critical to minimize the possibility of hazardous complications.
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This inter-agency guidance document aims to supplement the COVAX demand creation package for COVID-19 vaccines with key considerations for humanitarian contexts and marginalized populations with specific access and communication needs.
21 Sept.2021
Amoris laetitia: Post-Synodal Apostolic Exhortation on love in the family (19 March 2016)
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer
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e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp
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onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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The Lancet Published Online
October 8, 2021 https://doi.org/10.1016/ S0140-6736(21)02143-7
The coronavirus disease 2019 (COVID-19) pandemic has created a global and gendered crisis that is compounding existing inequalities and disproportionately affecting girls and women. Emerging evidence from the COVID-19 crisis in 2020 shows school closures, disruptions in essential services and rising
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poverty contributed to girls’ increased risk of female genital mutilation (FGM). School closures limited the monitoring and reporting of cases of FGM. Rising household monetary poverty may have contributed to families adopting negative coping mechanisms, including having girls undergo FGM as a precursor to marriage to reduce household costs. A report from the United Nations Population Fund (UNFPA) estimates 2 million additional cases of FGM by 2030 due to the pandemic.
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HIV drug resistance strategies focus on prevention through adherence and treatment optimization, surveillance to monitor resistance trends, and innovation in new drugs and diagnostics. Key approaches include implementing national action plans, strengthening laboratory capacity for monitoring, and pr
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oviding comprehensive care, especially for vulnerable populations
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Esta primeira versão de Medicamentos para prevenção da COVID-19: Orientação dinâmica da OMS aborda o uso de hidroxicloroquina para prevenção da COVID-19. Segue-se a publicação de uma análise sistemática e NMA que reuniu dados de seis estudos com 6.059 participantes que não tinham COVID-
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19 e receberam hidroxicloroquina. Três estudos envolveram participantes que tiveram uma exposição conhecida a uma pessoa com infecção por SARS-CoV-2. Em resposta à divulgação dos dados de estudos, o GDG da OMS desenvolveu recomendações sobre a hidroxicloroquina, um agente anti-inflamatório que atua por meio do bloqueio dos receptores Toll-like, reduzindo a ativação das células dendríticas. É usada para tratar a artrite reumatoide e o lúpus eritematoso sistêmico. Tem um efeito antiviral contra muitos vírus in vitro, inclusive o SARS-CoV-2, mas não foi demonstrado um efeito antiviral clinicamente útil para nenhuma infecção viral.
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Global Biodiversity Outlook (GBO) is the flagship publication of the Convention on Biological Diversity (CBD). It is a periodic report that summarizes the latest data on the status and trends of biodiversity and draws conclusions relevant to the further implementation of the Convention.
GBO-5 pro
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vides global summary of progress towards the Aichi Biodiversity Targets and is based on a range of indicators, research studies and assessments (in particular the IPBES Global Assessment on Biodiversity and Ecosystem Services), as well as the national reports provided by countries on their implementation of the CBD. The national reports provide rich information about the steps taken in countries worldwide in support of biodiversity conservation, sustainable use, and the fair and equitable sharing of benefits. This body of Information provides a wealth of information on the successes and challenges in implementing the Strategic Plan for Biodiversity 2011-2020 and in reaching the Aichi Biodiversity Targets.
This Outlook draws on the lessons learned during the first two decades of this century to clarify the transitions needed if we are to realize the vision agreed by world governments for 2050, ‘Living in Harmony with Nature’.
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