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2
The world is facing an unprecedented range of emergencies. In reaction to these complex adversities, many people experience considerable distress and impairment, and a minority may even go on to develop mental health conditions. Meanwhile, those with pre-existing mental health conditions may experie
...
nce a worsening of their condition and are at risk of neglect, abandonment, abuse and lack of access to support. Unfortunately, evidence-based mental health care is often extremely limited in humanitarian settings. In response, the World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR) published the Mental Health Gap Action Programme (mhGAP) Humanitarian Intervention Guide (mhGAP-HIG) in 2015. This practical tool supports health-care providers in assessing and offering first-line management of mental, neurological and substance use (MNS) conditions in humanitarian emergency settings.
2 December 2021. The current report, Stories of change from four countries: Building capacity for integrating mental health care within health services across humanitarian settings, describes efforts in four countries to build evidence-based mental health systems in humanitarian emergency settings using the mhGAP-HIG. This report includes three sections, the first describing the importance of scaling up mental health care in emergency contexts, the second outlining case studies (“stories of change”) to scale up the Mental Health Gap Action Programme (mhGAP) programme in four settings and the third describing lessons learned by stakeholders.
more
Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in Eastern and Southern Africa (ESA), with 26 per cent of new infections attributed to this population. AGYW face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention me
...
thods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, including for AGYW. Successful uptake and adherence to PrEP is critical in its effectiveness as an HIV prevention method, however, the current demand for PrEP by AGYW is low with suboptimal adherence.
Within the ESA region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa examines the current efforts in the region to accelerate and scale up evidence-based PrEP delivery platforms. The implementation brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.
more
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.
more
From the start of the COVID-19 pandemic until August 2021, extreme weather events have affected at least 139.2 million people and killed at least 17,242 people in at least 433 unique events. These figures are certainly an underestimate, as they do not include estimates of numbers of people affected
...
by extreme temperatures, or mortality during drought events.
One dimension of the compound risk of COVID-19 and climate extremes was the additional challenge of preparing for and responding to disasters during the pandemic, such as the constraints of physical distancing during evacuations and response operations.
more
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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This report challenges policy-makers and political leaders to tackle fossil fuel production and consumption as a health control issue, in the same way that smoking has been reduced and regulated. Fossil fuel combustion is a major source of toxic air pollution that kills 7 million people every year,
...
almost the same as the number of deaths caused by tobacco smoking.
In 2018, the World Health Organization (WHO) recognised air pollution as a major health risk factor. There is widespread public discussion about the effects of fossil fuel combustion and emissions on climate change… but what about the effect on our health? Climate change poses a threat not only to the health of the planet, but also to humans.
The case studies evaluated in this report offer examples of mechanisms that can be used to restrict the production and consumption of unhealthy commodities, so that the health, air pollution and climate communities can learn from one another, using shared approaches and language. These case studies show that the connection with health is a strong argument to support sustainable change.
more
The Planetary Health Report Card is a student-driven, metric-based initiative to inspire planetary health and sustainable healthcare education engagement in medical schools. In addition to inspiring expansion of medical school curricula, we hope to inspire medical schools to expand research efforts,
...
engage with communities most affected by climate change and environmental injustice, support passionate medical students who are trying to organize around planetary health at the institutional level, and implement sustainable practices. A set of metrics in these five category areas allows students and faculty to conduct a needs assessment at their medical school.
more
PHARMA’S RESPONSE TO THE COVID-19 VACCINES CRISIS. Update Feb., 14, 2022. In September 2021, Amnesty International published A Double Dose of Inequality, which assessed the extent to which the pharmaceutical industry was restricting access to Covid-19 vaccines. This report updates that
...
assessment of five leading vaccine manufacturers, AstraZeneca plc, BioNTech SE, Johnson & Johnson, Moderna Inc., and Pfizer Inc. It also includes for the first time an assessment of the two largest Chinese vaccine producers, China National Pharmaceutical Group Co., Ltd. (Sinopharm) and Sinovac Biotech Ltd. (Sinovac).
more
Contact tracing and quarantine in the context of COVID-19: interim guidance, 6 July 2022
recommended
Contact tracing for COVID-19 is the process of identifying, assessing, and managing people who have been exposed to someone who has been infected with the SARS-CoV-2 virus, while quarantine is the separation of contacts from other people after exposure to a probable or confirmed case of SARS-CoV-2 i
...
nfection. In the context of growing global population immunity from COVID-19 vaccination and past SARS-CoV-2 infection, WHO recommends that identification, contact, quarantine and follow-up should be prioritized for individuals at high risk who have been in contact with a confirmed or probable case of SARS-CoV-2 infection, rather than targeting all contacts. This updated guidance also introduces shorter recommended quarantine periods, including the ability to further shorten quarantine through the use of testing. National and local health authorities should use risk-based approaches to contact tracing and quarantine that include reviewing and adjusting to their local circumstances and disease epidemiology, population immunity, their health system’s capacities, and risk tolerance.
more
The substantial burden of death and disability that results from interpersonal violence, road traffic injuries, unintentional injuries, occupational health risks, air pollution, climate change, and inadequate water and sanitation falls disproportionally on low- and middle-income countries. Injury Pr
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evention and Environmental Health addresses the risk factors and presents updated data on the burden, as well as economic analyses of platforms and packages for delivering cost-effective and feasible interventions in these settings. The volume's contributors demonstrate that implementation of a range of prevention strategies-presented in an essential package of interventions and policies-could achieve a convergence in death and disability rates that would avert more than 7.5 million deaths a year.
more
Good Manufacturing Practice (GMP) describes a set of principles and procedures that, when followed, ensure that medicines and related substances are of high quality, safety and efficacy. SAHPRA is a
participating authority of the Pharmaceutical Inspection Cooperation Scheme (jointly known as PIC/S)
...
. PIC/S aims to develop international standards between countries and pharmaceutical inspection
authorities, to provide harmonised and constructive co-operation in the field of GMP. PIC/S affiliation is subject to initial and periodic assessment of the participating authority to ensure that it has equivalent legislation, regulatory and enforcement procedures and inspection capacity.
more
This report is part of the gender and noncommunicable diseases (NCDs) initiative launched by the WHO Regional Office for Europe, which aims to strengthen the response to NCDs through a gender approach. It is part of a series of country profiles and a synthesis report. The country profile of Ukraine
...
presents a gender analysis of the WHO STEPwise survey (STEPS) data to support international commitments to reducing the burden of NCDs with evidence and knowledge exchange. A gender analysis of STEPS NCD risk-factor survey data describes how risk factors for chronic diseases differ between and among men and women by exploring and tracking the direction and magnitude of trends in risk factors and accessing services by sociodemographic variables. Important differences hide even in sex-disaggregated data that need to be unpacked through sociodemographic characteristics, because men and women are not homogenous groups. The report also recognizes gaps in evidence and calls for further analysis of the impact of gender-based inequalities.
more
Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discharge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic o
...
r mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
more
In 2015, 26% of the deaths of 5.9 million children who died before reaching their fifth birthday could have been prevented
through addressing environmental risks – a shocking missed opportunity. The prenatal and early childhood period represents
a window of particular vulnerability, where enviro
...
nmental hazards can lead to premature birth and other complications,
and increase lifelong disease risk including for respiratory disorders, cardiovascular disease and cancers. The environment
thus represents a major factor in children’s health, as well as a major opportunity for improvement, with effects seen in every
region of the world.
more
Strengthening mental health responses to COVID-19 in the Americas: A health policy analysis and recommendations
A. Tausch; Oliveira e Souza, R.; Martinez Viciana, C.; et al.
Pan American Health Organization
(2021)
CC
The COVID-19 pandemic is having a major impact on the mental health of populations in the Americas. Studies
show high rates of depression and anxiety, among other psychological symptoms, particularly among women, young
people, those with pre-existing mental health conditions, health workers, and p
...
ersons living in vulnerable condi-
tions. Mental health systems and services have also been severely disrupted. A lack of financial and human resource
investments in mental health services, limited implementation of the decentralized community-based care approach
and policies to address the mental health gap prior to the pandemic, have all contributed to the current crisis. Coun-
tries must urgently strengthen their mental health responses to COVID-19 by taking actions to scale up mental
health and psychosocial support services for all, reach marginalized and at-risk populations, and build back better
mental health systems and services for the future.
more
Surveillance, case investigation and contact tracing for monkeypox: interim guidance 24 June 2022
recommended
The overall goal of surveillance, case investigation and contact tracing in this context is to stop human-to-human transmission to control the outbreak. The key objectives of surveillance and case investigation are to rapidly identify cases and clusters in order to provide optimal clinical care; to
...
isolate cases to prevent further transmission; to identify, manage and follow up contacts to recognize early signs of infection; to protect frontline health workers; to identify risk groups; and to tailor effective control and prevention measures.
more
Addressing gaps and improving health system performance is simply not enough to prepare a health system to tackle the effects of the climate crisis. Climate change’s impact on the health and well-being of people globally is reaching catastrophic levels. As the earth continues to warm, tens of mill
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ions of people are at increased risk from rapid and unpredictable spread of infectious diseases, heatwaves, water and food insecurity and scarcity, air pollution, poverty and homelessness. Health services are often regarded as a first line defense in preventing adverse health outcomes, especially from those caused by climate impacts
more
The United Nations Children's Fund (UNICEF), the International Organization for Migration (IOM), Georgetown University, and the United Nations University have today launched new guidelines to provide the first-ever global policy framework that will help protect, include, and empower children on the
...
move in the context of climate change.
The Guiding Principles for Children on the Move in the Context of Climate Change provides a set of 9 principles that address the unique and layered vulnerabilities of children on the move both internally and across borders as a result of the adverse impacts of climate change. Currently, most child-related migration policies do not consider climate and environmental factors, while most climate change policies overlook the unique needs of children.
The guidelines note that climate change is intersecting with existing environmental, social, political, economic, and demographic conditions contributing to people’s decisions to move. In 2020 alone, nearly 10 million children were displaced in the aftermath of weather-related shocks. With around one billion children – nearly half of the world’s 2.2 billion children – living in 33 countries at high risk of the impacts of climate change, millions more children could be on the move in the coming years.
Developed in collaboration with young climate and migration activists, academics, experts, policymakers, practitioners, and UN agencies, the guiding principles are based on the globally ratified Convention on the Rights of the Child and are further informed by existing operational guidelines and frameworks.
Recommendations for safeguarding the rights and well-being of children regardless of their location or migration status.
The guiding principles provide national and local governments, international organizations and civil society groups with a foundation to build policies that protect children’s rights. The organizations and institutions are calling on governments, local and regional actors, international organizations, and civil society groups to embrace the guiding principles to help protect, include, and empower children on the move in the context of climate change.
more
Many countries have made significant progress in the implementation of World Health Organization recommended preventive chemotherapy strategy, to eliminate lymphatic filariasis (LF). However, pertinent challenges such as the existence of areas of residual infections in disease endemic districts pose
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potential threats to the achievements made. Thus, this study was undertaken to assess the importance of these areas in implementation units (districts) where microfilaria (MF) positive individuals could not be found during the mid-term assessment after three rounds of mass drug administration.
more
One of the principles underpinning the delivery of all essential services and coordination of those services is the “survivor-centered approach”, which places the human rights, needs, and wishes of women and girl survivors at the centre of service delivery.
A key challenge faced by many entit
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ies working to end violence against women is ensuring that survivors’ voices and inputs are incorporated into policies, practices, and procedures on response. Survivors have diverse needs and face different risks. Not all women and girls experience violence in the same way. An effective intervention takes into account the realities of their unique circumstances, addresses individual needs, and reduces the risk for further harm and suffering.
UN Women, together with Global Rights for Women, have developed “Safe consultations with survivors of violence against women and girls”, which is designed to provide practical steps, safety measures, and actions that government agencies, civil society and survivor organizations, and United Nations’ entities can take to incorporate survivors' voices into systemic reform efforts, through safe and meaningful consultations.
This guidance is intended to help policymakers develop survivor-centered programming on ending violence against women and girls that meets the needs of diverse groups of women and girls, including those who are at higher risk of experiencing violence and discrimination. It is applicable to programming across the health, justice and policing, and social services sectors, as well as coordination of these sectors, and will help improve the standard and delivery of essential services for women and girls who have experienced violence.
more
