The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp...ressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
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MICROBIAL DRUG RESISTANCEVolume 24, Number 5, 2018ªMary Ann Liebert, Inc.DOI: 10.1089/mdr.2017.0383
Antibiotic resistance (ABR) is a worldwide publichealth concern, with serious health, economic, and so-cietal repercussions. Its emergence is attributed to the se-lective pressure exerted by antib...iotic use in the community, hospitals, veterinary health, agriculture, aquaculture, and the environment. Additionally aggravating the situation is the fact that very few new antibiotics have recently been produced by pharmaceutical companies. It is widely acknowledged that food animals are key reservoirs of antibiotic-resistant bacteria and that antibiotic usage in this population favors the emergence, selection, and spread of resistance among animals and humans, both through zoonoses (infectious diseases trans-mitted between animals and humans) and the food chain.
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Following the high-level meeting of the UN General Assembly on antimicrobial resistance held in September 2016 which called for national, regional and international political commitment to address the issue, member countries agreed on the importance of moving forward to develop national action plans... by May 2017.
Iraq; represented by the Ministry of Health (MOH) and Ministry of Agriculture (MOA); responded by developing a comprehensive plan to control AMR by analysing the current situation of health, veterinary and environment and determining the strategic priorities for Iraq, which are in accordance with the WHO Global Action Plan objectives
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Although the COVID-19 crisis is, in the first instance, a physical health crisis, it has the seeds of a major mental health crisis as well, if action is not taken. Good mental health is critical to the functioning of society at the best of times. It must be front and centre of every country’s resp...onse to and recovery from the COVID-19 pandemic. The mental health and wellbeing of whole societies have been severely impacted by this crisis and are a priority to be addressed urgently.
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The arrival of COVID-19 in Afghanistan has brought heartache to millions of people who are now battling a deadly pandemic while simultaneously fighting for their survival amid poverty, disaster and war. Over my three years as Humanitarian Coordinator, I have marvelled at the resilience of the people... of this country to cope with the hardships of life in the world’s deadliest conflict – but even this remarkable strength is now being tested by the health, social and economic consequences of COVID-19. The virus is spreading across the country with frightening speed. Every province is now impacted, and people are understandably frightened.
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he central Sahel region—Burkina Faso, Mali and Niger—is facing a severe humanitarian and protection crisis.
Massive displacement, most of it driven by intense and largely indiscriminate violence perpetrated by a range of armed actors against civilian populations, is taking place across the regi...on. While internal displacement is on the rise substantial numbers of refugees have fled to neighboring countries, and the situation risks spilling over into the coastal countries of Benin, Côte d'Ivoire, Ghana, and Togo.
This context is exacerbated by the COVID-19 pandemic, which is already affecting areas hosting refugees and IDPs
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7 June 2020 Version 1
Women in Myanmar have traditionally been underrepresented in public decision-making processes, a trend which is continuing in structures established to respond to COVID-19. This means that even as women are disproportionately affected by the crisis, they have less say in how t...heir communities and country respond to it, increasing the risk of a COVID-19 response that does not adequately address the needs and priorities of the most vulnerable women and girls.
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In 1964 medical mission was challenged and called to define its distinctiveness and its special role in the context of that particular time. The consultation "Tuebingen I" clearly stated: "The Christian church has a specific task in the field of health and healing"1, and developed a conce...pt of wholeness and of the role of the congregation in health provision. 50 years later, the question of the proprium of Christian health services is again a very important one. At a time when governments, international non-governmental organizations and other philanthropic organizations participate in health care, the question has to be asked: What is the specific contribution of a Christian health service or ministry of healing? At a time when chronic disease challenges not only rich but now also poor countries, when infections like Ebola that for years were hidden in Africa pose a threat to the global situation, Christians have to reflect on the question of the proprium of Christian health care.
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Practical considerations
It provides more detailed and practical guidance for continuing services for each life stage across the life-course continuum. As such, both documents should be read and used together. The countries in South-East Asia and the Pacific regions would like to adapt the guidance... within the national and sub-national continuity plans, based on the local situation of COVID-19 transmission, containment response and health system capacity.
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With about 24 million of Yemen’s 30 million people in need of some form of assistance, the United Nations calls Yemen the world’s worst humanitarian crisis. Cholera and other disease outbreaks are common, malnutrition is widespread, water is scarce, and the healthcare system is crumbling, with o...nly half of the country’s 5,000 or so health facilities fully operational and with massive medical supply and staff shortages. In August 2020, the UN warned the country was again on the brink of full-scale famine.
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9 September 2020
In a snapshot, fair allocation of vaccines will occur in the following way:
An initial proportional allocation of doses to countries until all countries reach enough quantities to cover 20% of their population
This document is also available in Arabic | Chinese | French | R...ussian | Spanish | Portuguese
A follow-up phase to expand coverage to other populations. If severe supply constraints persist, a weighted allocation approach would be adopted, taking account of a country’s COVID threat and vulnerability.
The document is a final working document and may be adjusted in the future as new information about the vaccines and the epidemiology of COVID-19 becomes available.
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It describes and analyzes the theoretical-practical incidences of misinformation, disinformation, and malinformation, including but not limited to the Information Science framework. Besides, it aims to outline an understanding of these three concepts based on 16 arrangements intercon...nected according to their intentionality.
Conclusions: We highlight that the complexity that permeates the various fields in the present situation is due to the difficulty of reaching a consensus on the semantic definition of the concepts of information, misinformation, and its disambiguations since these concepts have various properties.
Also available in: Portuguese
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13 May 2021
To avoid a reversal of progress from the adverse impacts of the COVID-19 pandemic, new knowledge and lessons from successful programmatic innovations are urgently needed to improve TB prevention and care. Experience can provide evidence for innovative approaches and strategies to mainta...in and scale up high-quality TB services. WHO therefore called for case studies on programmatic innovations that address emerging challenges in TB prevention and care during the pandemic in order to collect and disseminate the findings to the TB community. Between November 2020 and February 2021, a total of 23 case studies relevant to the call were accepted from 19 countries in the six regions of WHO. The lessons learnt from these country activities to ensure the continuity of essential services like TB care in the face of the crippling crisis may also inform strategies for minimizing the impact of future emerging pathogens on health services.
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The right to adequate housing, despite having been recognized by multiple international instruments, continues to be a human right that is consistently violated. Around 2O% of the world's population do not have adequate housing . In Latin America, informal settlements generally lack the conditions r...equired to live a decent life, and local and national public policies fail to radically transform this situation.
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Modelling the health impacts of disruptions to essential health services during COVID-19 Module 1
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVI...D-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effective as possible. With this in mind, this manual is... intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
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This guide is designed to accompany the training module, Communicating with health workers about COVID-19 vaccination. It provides detailed explanations, resources and guidance to accompany the slides in the training module and support those implementing the training. It is intended for training fac...ilitators or trainers of trainers (ToTs) who will be conducting the training at the country level either face-to-face or online with a group of participants. Facilitators can use this guidance document to help them adapt the training content to their local context and facilitate discussion with training participants. Facilitators are encouraged to have this guide available to them as a tool during the training session.
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The COVID-19 pandemic arrived in an evolving epidemiological context where some countries are experiencing a progressive decrease in HIV positivity in their testing programme as they are moving closer to the first 95 target. Distinguishing changes in HIV testing services due to the COVID-19 pandemic... from those resulting from evolving HIV testing strategies is crucial for adapting services and helping countries define their strategic mix of testing options moving forward. There is a need to focus, prioritize and plan for strategic efforts to prevent going further off the track toward achieving global targets and goals.
To support these efforts, WHO in partnership with ministries of health conducted an in-depth analysis of HIV testing services and antiretroviral therapy (ART) initiation prior to and during reported COVID-19 disruptions. Additional publicly available Global Fund and PEPFAR data was also reviewed and analysed. This analysis, and coordination with ministries of health, identified key service delivery adaptations utilized during COVID-19-related disruptions and formed the basis of this strategic guide.
This document focuses on current country needs, as well as plans for prioritization and potential surge support needs in the event of future disruptions. Although the data and implications are specific to sub-Saharan Africa, key principles and lessons can be applied elsewhere.
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This report provides updated data on suicide in the Region of the Americas and is issued every five years, this being the fourth edition. In addition to including analysis similar to previous reports (suicide according to age, sex, as well as methods used), this report includes an expanded set of an...alysis on risk factors for suicide in the Americas: the analysis of the annual age-standardized gender-specific suicide mortality rate trends over time by country and sub-region and to identify points of inflection, and evaluates the association of specific risk factors on country-level suicide mortality rates.
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These guidelines provide a framework for effective action to facilitate access to safe and ethical
testing services for different population groups. The implementation of the a comprehensive
approach, known as HIV Testing Services (HTS) is cardinal as an effective package of services
that diminis...hes the impact of the HIV epidemic in our country. All forms of HTS adhere to
the 5Cs: Confidentiality, Counselling, Consent, Correct results and Connection, or linkage
to care, with all based within a human right context. In addition to the 5Cs, however, the
MOHCDGEC emphasizes the use of a variety of approaches to HTS that will reduce the
number of missed opportunities. These include Provider-Initiated Testing and Counselling
testing, Couple counselling and testing, Index testing, and infant and children counselling and
testing in alignment to the revised WHO guidelines. Furthermore, these guidelines accentuate
on the continual provision of integrated HTS service at all levels of the public and private
health service delivery system.
The HTS Providers, managers and other stakeholders
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