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Issue Brief 31: Antimicrobial resistance (AMR) can occur when viruses, bacteria, parasites and fungi change over time. There is no longer a response to medicines, and the infection treatment gets really difficult which increases the risk of a disesa
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se spread, which can lead to severe health problems. AMR is an increasing threat to global public health worldwide that requires cross-sectional and cross-disciplinary action. It is present in every country and is spurred by several human-made factors, including over- and/or inadequate use of antibiotics, poor hygiene and infection prevention control, and excessive usage of antibiotics outside the health care sector e.g. in life stock production.
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Forests and Trees for Human Health: Pathways, Impacts, Challenges and Response Options
Cecil Konijnendijk, Dikshya Devkota, Stephanie Mansourian & Christoph Wildburger (eds.)
International Union of Forest Research Organizations (IUFRO)
(2023)
C2
Forests, trees and green spaces, hereinafter ‘forests and trees’ for short, provide multiple goods and services that contribute to human health. These include medicines, nutritious foods and other non-wood forest products (NWFPs). Globally, at l
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east 3.5 billion people use NWFPs, including medicinal plants, which are particularly important for vulnerable groups and Indigenous Peoples and local communities (IPLCs).
During periods of crises, such as the COVID-19 pandemic, demand for forest products typically increases amongst these groups. Forests and trees also contribute to better health by playing a role in climate change
mitigation and adaptation, contributing to regulating the carbon cycle, but also moderating the micro-climate, filtering pollutants from the air and protecting settlements against the effects of extreme events such as droughts and flash floods.
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We are pleased to offer the NCD kit online training course for emergency managers and technical staff in emergencies to ensure rapid, adequate and cost-effective use of the existing Noncommunicable Disease (NCD) kit in emergency health operations to
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reduce the vulnerability of affected communities and address their priority health needs. The NCD kit is a pre-packed set of essential medicines and medical devices to meet priority noncommunicable disease (NCD) needs of an outreach population of 10 000 people for three months in emergencies, when medical facilities and regular supply has been disrupted. The training aims to assist all those involved in leading and coordinating health emergency operations, assessing the needs, planning for supplying, implementing and monitoring the continuity of essential NCD services at all levels of emergency management.
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WHO Technical Report Series, No. 961, 2011, Annex 8 - These guidelines are intended to provide a description of ways in which pharmacists can improve access to health care, health promotion and the use of
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medicines on behalf of the patients they serve. The role of FIP is to provide leadership for national pharmacy professional organizations, which in turn provide the impetus for setting national standards. The vital element is the commitment of the pharmacy profession worldwide to promoting excellence in practice for the benefi t of those served. The public and other professions will judge the pharmacy profession on how its members translate that commitment into practice in all settings, especially community and hospital pharmacy settings.
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This book is a practical manual of mental health care for community health workers, primary care nurses, social workers and primary care doctors, particularly in developing countries.Helpful features include: over 50 illustrations and case studies, jargon-free explanations and descriptions, flow-cha
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rts on common clinical problems, and a practical guide to the use of psychiatric medicines and simple psychological treatments.
Chapters 1, 9 and 10 can be found on the e-TALC CD-ROM number 2 (April 2003). See www.talcuk.org for details Links to Chapters 2 and 3 above. Printed copies of this book can also be obtained from the Royal College of Psychiatrists www.rcpsych.ac.uk/wnitp
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WHO Pharmacovigilance indicators: a practical manual for the assessment of pharmacovigilance systems
This manual provides a practical method for determining the pharmacovigilance indices. It is designed to be simple and can be understood by any worker in pharmacovigilance without formal training in monitoring and evaluation. Pharmacovigilance as a medical discipline is crucial in preventing medicin
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e-related adverse effects in humans, promoting patient safety, and the rational use of medicines. The indicators proposed in this manual are based on the expected functions of pharmacovigilance centres as described in the WHO Mimimum Requirements for a Functional Pharmacovigilance System (1) (see Annex 1 of the manual).
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This policy brief has been developed in response to the contemporary challenge of antibiotic resistance (ABR). ABR poses a formidable threat to global health and sustainable development. It is now increasingly recognized that the systematic neglect of cultural factors is one of the biggest obs
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tacles to achieving better health outcomes and better standards of living worldwide. Using a cultural contexts of health approach, the policy brief explores the centrality of culture to the challenge of ABR. The brief examines how the prescription and use of antibacterial medicines, the transmission of resistance, and the regulation and funding of research are influenced by cultural, social and commercial, as well as biological and technological factors. The brief moves beyond the ready equation of culture with individual behaviours and demonstrates how culture serve as an enabler of health and provide new possibilities for change.
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The objectives of these WHO guidelines are to provide updated evidence- based recommendations for the treatment of persons with hepatitis C infection using, where possible, all DAA-only combinations. The guidelines also provide recommendations on the preferred regimens based on a patient’s HCV gen
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otype and clinical history, and assess the appropriateness of continued use of certain medicines. This document also includes existing recommendations on screening for HCV infection and care of persons infected with HCV that were first issued in 2014
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The publication of the Second Edition of the Emergency Drug Guidelines represents the culmination of the efforts of the National Drugs and Therapeutics Committee (NDTC) to publish clinical drug guidelines for common diseases seen in Fiji. These guidelines are targeted for health care professionals w
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orking at hospitals and at the primary health care settings. It sets the gold standard for the use of drugs in the treatment of emergency medical conditions in Fiji. The guidelines have taken into account the drugs available in the Fiji Essential Medicines Formulary (EMF), 2006 Edition, in recommending treatment approaches. All recommended therapies are either evidencebased or universally accepted standards
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Traditional medicine, including the knowledge, skills and practices of holistic health care, exists in all cultures. It is based on indigenous theories, beliefs and experiences and is widely accepted for its role in health maintenance and the treatment of disease.Medicinal plants are the main ingred
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ients of local medicines, but rapid urbanization is leading to the loss of many important plants and knowledge of their use. To help preserve this knowledge and recognize the importance of medicinal plants to health care systems, the WHO Regional Office for the Western Pacific has published a series of books on Medicinal Plants in China, the Republic of Korea, Viet Nam and the South Pacific. Medicinal Plants in Papua New Guinea is the fifth in this series. This book covers only a small proportion of the immense knowledge on traditional medicine, the plant species from which they are derived, the diseases they can treat and the parts of the plants to be used. The diverse cultures, languages and traditional practices of Papua New Guinea made this a particularly challenging project. But we believe the information and accompanying references can provide useful information for scientists, doctors and other users.
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The issue of Antimicrobial resistance has become one of the most substantial health issues, prompting the World Health Assembly (WHA) to urge Member States to finalise tailor made national action plans by May 2017, aligning them with objectives of the Global Action Plan (GAP). These cover awareness,
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surveillance and research, hygiene infection prevention & control, optimal use of antimicrobial medicines and economic case for sustainable investment. Indonesia, by virtue of its geographical terrain and complex interactions with diverse stakeholders, indicates a higher burden of AMR. Most of the country’s data currently relies on local studies conducted by labs and universities. To get a more accurate estimate of the situation, one has to rely on results from the Regional Resistance Surveillance Programme. By undertaking such measure, Indonesia would acquire data to detect AMR trends at a national level.
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Since the introduction of penicillin in the early twentieth century, antimicrobial treatments have been utilized not only in human medicine but also in veterinary care – initially to ward off diseases, prevent post-surgery infections, and treat sick farm animals.Global food production
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has intensified over the past 50 years due to economic expansion and popu-lation growth. The use of antimicrobials in agriculture – in livestock, fish farming, and even on crops – has grown as well. Antimicrobials are not only used as medicines, but are sometimes also added in low concentrations to animal feed as a way of stimulating growth.
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Our target end-users are those with limited literacy. It is a challenging task to achieve success in this group as so much of what is "obvious" to those of us with good literacy skills is totally obscure to those who have never had the opportunity to learn the meaning of e.g. an arrow shape and what
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it is meant to represent. Our pictograms have been tested mainly in our local Xhosa population, so we cannot guarantee universal generalisability (as is the case for any other pictograms). Categories in the database include Dosage and frequency; Route of administration; Additional medicine instructions; Side effects or indications; Storage of medicines; Tablets, capsules, bottles, droppers; Miscellaneous; TB-related pictograms
A common application relates to their use with medicines where they may serve to convey instructions, precautions, storage requirements, warnings, as well as medicine indication or side effects to patients or consumers. Many examples of diverse application of pictograms in the health literature have been described including health promotion materials, wound care instructions, asthma prevention and treatment, injury prevention, discharge instructions, self-care guidance, paediatric anaphylaxis plan, organ and body donation, CT scan risks and benefits, driving risks, safety symbols, decision aids for treatment, and patient-reported outcomes dashboards, amongst others.
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For 50 patients requiring surgical care in emergency situations assuming 2 operations per patient (100 interventions)
WHO trauma and emergency surgery kit (TESK) aims to provide materials and drugs to meet the needs of 50 patients requiring surgical care in emergency situations, assuming an avera
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ge of two operations per patient. This kit is intended for use by health care providers who are trained in appropriate management of emergent surgical issues and are acting within their scope of practise. It is designed for use in areas where basic levels of infrastructure exist. The composition of TESK has recently been revised in collaboration with the International Committee of the Red Cross to meet the dynamic requirements of emergency situations. In general, this kit contains oral and IV medicines including cold chain drugs and medical supplies including renewables and instruments.
WHO TESK is intended to provide the resources needed for surgical procedures in operating theatres. Some of the sub-units may be used for simpler procedures that may occur in other parts of the facility.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (
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SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Key facts
- Cardiovascular diseases (CVDs) are the leading cause of death globally.
- An estimated 17.9 million people died from CVDs in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attack and stroke.
- Over three quarters of CVD deaths take place in low- an
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d middle-income countries.
- Out of the 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2019, 38% were caused by CVDs.
- Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol.
- It is important to detect cardiovascular disease as early as possible so that management with counselling and medicines can begin.
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Antimicrobial resistance (AMR) is occurring everywhere in the world, compromising the ability to treat infectious diseases, as well as undermining many other advances in health and medicine. Underlying factors that drive AMR include; weak or absent surveillance and monitoring systems, inadequate sys
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tems to ensure quality and uninterrupted supply of medicines, inappropriate and irrational use of medicines including in animal husbandry, poor infection prevention and control practices, and depleted arsenals of diagnostics, medicines and vaccines as well as insufficient research and development of new products.
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This report aims to support countries in the necessary transition toward healthier, more sustainable diets by integrating biodiversity in food-based interventions to support nutrition and health. It is intended to help guide decision-makers in the health, nutrition and other sectors, to:
Consider
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the important role of biodiversity in food systems for the development of integrated interventions to support healthy, diverse and sustainable diets;
To focus investments and country support for more comprehensive, coordinated and cross-cutting public health and nutrition projects and policies; and
To strengthen the resilience of food systems, health systems, and societies, each of which are each increasingly compromised by widespread ecological degradation, biodiversity loss and climate change.
Biodiversity at every level (genetic, species and ecosystem level) is a foundational pillar for food security, nutrition, and dietary quality. It is the basic source of variety in essential foods, nutrients, vitamins and minerals, and medicines, and underpins life-sustaining ecosystem services. It is a core environmental determinant of health, often a vital ingredient of healthy nutritional outcomes and livelihoods, gender equality, social equity, and other health determinants.
Biodiversity can play a more prominent role in planning for nutritional outcomes in various ways, e.g. by facilitating the production of nutritious fruits and plant products, sustaining livelihoods through more efficient production and increasing the diversity of products available in markets. This Guidance presents and expands on six core building blocks for mainstreaming biodiversity for nutrition and health:
Cross-sectoral knowledge development and knowledge co-production;
Enabling environments;
Integration;
Conservation and the wider use of biodiversity;
Education and awareness-raising;
Monitoring and evaluation;
This WHO report builds on an unprecedented opportunity to mainstream biodiversity in order to support healthy and sustainable diets, and offers the necessary technical guidance to catalyze and support a transformation of the global food system and transition to healthier, more sustainable diets.
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Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security and safety, environmental effects on ecosystems and biodiversity, and
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socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”.
The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines.
Its strategic objectives include:
• improving the awareness and understanding of AMR;
• strengthening the knowledge and evidence base through surveillance and research;
• reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and
• developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions.
With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives
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After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery, pre-clinical development, and operational challenge
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s of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
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