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This document is based on currently available scientific evidence on treatment for drug use disorders and sets out a framework for the implementation of the Standards, in line with principles of public health care. The Standards identify major components and features of effective systems for the tre
...
atment of drug use disorders. They describe treatment modalities and interventions to match the needs of people at different stages and severities of drug use disorders, in a manner consistent with the treatment of any chronic disease or health condition. The Standards are aspirational, and such, national or local treatment services or systems need not attempt to meet all the standards and recommendations made in this document all at once. However over time, progressive quality improvement, with ‘evidence-based and ethical practice’ as an objective, can and should be expected to achieve better organized, more effective and ethical systems and services for people with drug use disorders.
more
A living WHO guideline on drugs for covid-19
recommended
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379
Rapid Recommendation and visual graph. This is the fifth version (update 4) of the living guideline (BMJ 2020;370:m3379). When citing this article, please consider adding the update number and date of access for clarity. The publication of the RE
...
COVERY and REMAP-CAP randomised controlled trials triggered this guideline update, resulting in a strong recommendation for interleukin-6 (IL-6) receptor blockers (tocilizumab or sarilumab) in patients with severe or critical covid-19.
Prior recommendations: (a) A recommendation not to use ivermectin in patients with covid-19, regardless of disease severity, except in the context of a clinical trial; (b) a strong recommendation against the use of hydroxychloroquine in patients with covid-19, regardless of disease severity; (c) a strong recommendation against the use of lopinavir-ritonavir in patients with covid-19, regardless of disease severity; (d) a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19; (e) a conditional recommendation against systemic corticosteroids in patients with non-severe covid-19; and (f) a conditional recommendation against remdesivir in hospitalised patients with covid-19.
more
Les pays du monde entier sont confrontés à des situations épidémiologiques diverses, et disposent de capacités de réaction différentes et d’un accès inégal aux outils permettant de sauver des vies. L’Organisation mondiale de la Santé (OMS) recommande aux autorités nationales de contin
...
uer à appliquer une approche fondée sur les risques lorsqu’elles mettent en œuvre des mesures relatives aux voyages internationaux dans le contexte de la COVID-19, tout en respectant la dignité, les droits humains et les libertés fondamentales des voyageurs. Cette approche doit prendre en compte le risque d’importation et d’exportation de cas posé par les voyages dans le cadre de l’évolution de la situation épidémiologique, y compris de l’émergence et de la circulation de variants préoccupants du SARS-CoV-2, du déploiement de la vaccination contre la COVID-19 et des enseignements tirés de la riposte à la pandémie, notamment en ce qui concerne la détection précoce et la prise en charge des cas, ainsi que l’application de mesures sociales et de santé publique.
more
Interim guidance, 26 October 2021
This interim guidance has been developed on the basis of the advice issued by the Strategic Advisory Group of Experts (SAGE) on Immunization at its meeting on 5 October 2021.
SAGE said moderately and severely immunocompromised persons should be offered an addition
...
al dose of all WHO approved vaccines “since these individuals are less likely to respond adequately to vaccination following a standard primary vaccine series and are at high risk of severe COVID-19 disease.”
People aged 60 and older who received the Sinovac and Sinopharm vaccines should get a third dose too, the experts added, though use of other vaccines may also be considered depending on supply and access.
“When implementing this recommendation, countries should initially aim at maximizing 2-dose coverage in that population, and thereafter administer the third dose, starting in the oldest age groups”, they said.
SAGE has also reviewed a vaccine developed by Indian company Bharat Biotech and will issue a policy recommendation after WHO greenlights it for emergency use.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat
...
e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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To support countries in adapting their response to different COVID-19 scenarios, the World Health Organization (WHO) Department of Maternal, Newborn, Child and Adolescent Health and Ageing commissioned this scoping review of published and grey literature. The objective was to identify interventions
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implemented to maintain the provision and use of essential services for MNCAAH during disruptive events and to summarize lessons learned during these interventions. The review included outbreaks of Ebola virus disease (EVD), severe acute respiratory syndrome (SARS), Zika virus disease (ZVD), the ongoing COVID-19 pandemic, and natural disasters and humanitarian emergencies that caused disruption to services, transport and other activities.
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The One Health approach can help achieve progress and promotes synergies on national and global priorities by generating synergies at the human-animal-environmental interface. While evidence is still scare, it is likely that the approach is highly cost-effective and improves effectiveness of core pu
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blic health systems, through reducing morbidity, mortality, and economic costs of disease outbreaks. It also contributes to economic development through strengthening public health systems at the human-animal-environment interface protects health, agricultural production, and
ecosystem services
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There is a broad consensus nowadays that the Earth is warming up as a result of greenhouse gas emissions caused by anthropogenic activities. It is also clear that current trends in the fields of energy, development and population growth will lead to continuous and ever more dramatic climate change.
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This is bound to affect the fundamental prerequisites for maintaining good health: clean air and water, sufficient food and adequate housing. The planet will warm up gradually, but the consequences of the extreme weather conditions such as frequent
storms, floods, droughts and heat-waves will have sudden onset and acute repercussions. It is widely accepted that climate change will have an impact on the spread of infectious diseases in Europe, which is likely to bring about new public health risks in the majority of cases. Transmission of infectious diseases depends on a number of factors, including climate and environmental elements. Foodborne and waterborne diseases, for instance, are associated with high temperatures. Disease-transmitting vectors (e.g. mosquitoes, sandflies and ticks) are highly sensitive to climate conditions, including temperature and humidity; their geographical distribution will widen as climate conditions change, potentially allowing them to spread into regions where they are not currently able to live.
The primary purpose of this manual on climate change and infectious diseases is to raise the awareness and the level of knowledge of health workers at national, regional and local levels in the former Yugoslav Republic of Macedonia on the health risks associated with climate change and infectious diseases. This manual was devel-
oped as part of the WHO Regional Office for Europe project, Protecting health from climate change: a seven–country initiative, implemented with financial support from the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety.
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Viele der derzeit in Deutschland lebenden Älteren mit Migrationsgeschichte sind im Zielland ihrer Migration unter spezifischen Bedingungen, die mit dem Migrations- und Integrationsprozess einhergehen können, älter geworden. Allerdings ist bislang wenig über diese Gruppe bekannt. Wie wirkt sich d
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as biografische Ereignis „Migration“ auf die Lebensqualität, die sozioökonomische Situation und die Gesundheit im Alter aus? Welche Unterschiede gibt es zwischen der älteren Bevölkerung mit und ohne Migrationsgeschichte? Diese Research Note gibt einen Überblick über die einschlägige Forschungsliteratur. Sie beschreibt den Forschungsstand in ausgewählten Lebensbereichen und identifiziert Erkenntnislücken sowie zukünftige Forschungsfragen an der Schnittstelle Migration und Alter(n). Darüber hinaus wird die Lebenssituation älterer Menschen mit Migrationsgeschichte nicht nur dargestellt, sondern auch zugrunde liegende Ursachen für mögliche Unterschiede in den Lebensverhältnissen im Vergleich zu Gleichaltrigen ohne Migrationsgeschichte skizziert.
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The health and socioeconomic crisis triggered by the COVID-19 pandemic has hit the countries of Latin America hard and laid bare the profound inequities about which numerous international, regional and national reports have sounded warnings in recent decades. In this context, the historical politica
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l and economic exclusion and marginalization of the more than 800 indigenous peoples in the region has been accentuated as a result of insufficient State responses to the crisis, which have not adequately considered the collective rights of these peoples and have had little cultural relevance.
This document provides an overview of the situation of indigenous peoples in the region in the face of the COVID-19 pandemic. It analyses both the State’s and indigenous peoples’ own responses to the crisis, as well as offering a set of recommendations to rectify the neglect of these peoples in the management of the pandemic, centring on their collective rights.
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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control in these communities, it is necessary to respond t
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o communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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Self-care interventions are among the most promising and exciting new approaches to improve health and well-being, both from a health systems perspective and for people who use these interventions.
The World Health Organization (WHO) uses the following working definition of self-care: Self-care i
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s the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker. The scope of self-care as described in this definition includes health promotion; disease prevention and control; self-medication; providing care to dependent persons; seeking hospital/specialist/primary care if necessary; and rehabilitation, including palliative care. It includes a range of self-care modes and approaches. While this is a broad definition that includes many activities, it is important for health policy to recognize the importance of self-care, especially where it intersects with health systems and health professionals.
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Latin America and the Caribbean is characterized by a matrix of social inequality whose axes —such as
socioeconomic stratum, gender, stage in the life cycle, ethnicity and race, territory, disability, and immigration
status— create multiple, often concurrent, situations of exclusion and discri
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mination. The coronavirus
disease (COVID-19) pandemic has exacerbated wide social gaps and it is no coincidence that Latin America
and the Caribbean is one of the regions in which the health and socioeconomic impacts of the pandemic have
been the most severe, which shows that the costs of inequality are unsustainable
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La publication des résultats de l’EDSC-V intervient quelques années seulement après l’échéance en 2015 des Objectifs du millénaire pour le développement (OMD), le lancement de l’Agenda 2065 de l’Union Africaine, de l’Agenda 2030 des Nations Unies pour le Développement Durable, et a
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u moment de la finalisation de la
Stratégie nationale de développement de la deuxième génération (2020-2027) dans le cadre de la Vison 2035.Nul doute qu’ils serviront à établir la situation finale ou la situation de référence pour le suivi évaluation des progrès accomplis dans le cadre de ces agendas nationaux et internationaux.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel
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erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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This Mpox SPRP Global Monitoring & Evaluation (M&E) Framework, also referred to as the Framework, aims to monitor and report on global progress towards these objectives, including information about country-level response efforts and WHO support to Member States. Regular collection and analysis of da
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ta on these objectives, alongside the ongoing tracking of the epidemiological situation, are key to informing decision-making, operational adjustments, as well as ensuring transparency and accountability for achieving the goal to stop the Mpox outbreak. This document suggests reporting indicators for monitoring of the global response to the Mpox PHEIC as articulated in the Mpox SPRP and Operational Planning Guidelines for countries.
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Conformément aux dispositions de l’article 19 de la Constitution de l’Organisation internationale du Travail (OIT), le Conseil d’administration, à sa 334e session (octobre-novembre 2018), a décidé que l’Étude d’ensemble qui devait être préparée par la Commission d’experts pour l
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application des conventions et recommandations (CEACR) en 2020 et présentée à la
Conférence internationale du Travail (la conférence) en 2021 porterait sur quatre instruments relatifs au travail décent pour les travailleurs du soin et des services à la personne dans une économie en évolution: la convention (no 149) et la recommandation (no 157) sur le personnel infirmier, 1977, la convention (no 189) et la recommandation (no 201) sur les travailleuses et
travailleurs domestiques, 20111 . L’Étude d’ensemble examinerait en profondeur la situation en droit et en pratique des travailleurs du soin et des services à la personne au regard des conventions nos 149 et 189.
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Le présent document rassemble une série de recommandations émises par l’Organisation mondiale de la Santé (OMS) et l’Organisation panaméricaine de la Santé (OPS) pour aider les professionnels chargés des programmes de lutte antivectorielle en Amérique latine et dans les Caraïbes aux niv
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eaux national, infranational et local à mettre à jour et prendre des decisions à base factuelle qui touchent les mesures de lutte antivectorielle les mieux adaptées à chaque situation particulière. La GIV peut être utilisée lorsque la cible est la surveillance et la lutte ou l’élimination (en function de chaque situation) des MTV et peut contribuer à réduire le développement de la résistance aux insecticides au moyen de l’utilisation rationnelle de ces produits. Le présent document contient les instructions nécessaires pour mener à bien le mandat établi par l’OPS en 2008 (résolution CD48.R8, document CD48/13), en particulier, il complémente une série de guides de l’OMS publiés en 2012
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After five consecutive below-average rains, the humanitarian crisis in the Horn of Africa is expanding and deepening.
Combined with insecurity and macroeconomic volatility, the impact of the drought on food and nutrition security has been devastating. Across Ethiopia, Kenya and Somalia, an estima
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ted 22 million people are now acutely food insecure because of the drought. The malnutrition situation is also critical. Some 5.1 million children across drought-affected areas of the three countries are acutely malnourished in 2023, with dire implications for their health, growth and survival. Concerningly, the upcoming March-May 2023 rains are also forecast to be below-average. Should these rains fail, and humanitarian assistance not be delivered at scale, food insecurity will continue to deteriorate.
Regardless of how the 2023 rains perform, extremely high humanitarian needs will persist through 2023 while a full recovery from a drought of this magnitude will take years. To address the devastating drought-induced hunger and malnutrition across the region, WFP is pursuing an integrated dual track approach; meeting immediate life-saving food and nutritional needs while simultaneously building resilience to extreme climate variability.
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PLoS Negl Trop Dis 16(10): e0009774. Although the practice of communication is often called upon when intervening asn involgvingcommunties affected by NTD's, the disciplinary framewokr of healt communication research has been largely absent from NTD strategies. To illustrate how practices conceptual
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ized and developed within the communication field habe been applied in the context of NTD elimination, we conducted a scoping review focusing on two diseases currently targeted for elimination by the WHO: lymphatic filariasis and Chagas disease
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