A case study from Bosnia and Herzegovina Eurasian Harm Reduction Network
The case study was prepared by Samir Ibisevic, President of PROI between March and June 2016 and edited by Graham Shaw.
EHRN is grateful to all who contributed to this document, especially: Dr. Serifa Godinjak, Chairperson... of Country Coordinating Mechanism; Dr. Zlatko Cardaklija, HIV Coordinator for the Federation of Bosnia and Herzegovina (BiH); Dr. Nesad Seremet, Head of the HIV program, United Nations Development Program in Bosnia and Herzegovina; Ms. Gyongyver Jakab, Fund Portfolio Manager, Eastern Europe and Central Asia and Ms. Natalya Bogach, Program Officer, The Global Fund to Fight AIDS, Tuberculosis and Malaria; Dr. Nermana Mehic–Basara, Director of the Institute for Addiction Diseases of Sarajevo Canton; Mr. Denis Dedajic, Director of the Association Margina from the Federation of BiH; Mr. Srdjan Kukolj, Director of Action Against AIDS from the Republic of Srpska.
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This guideline provides global, evidence-informed recommendations on a number of specific issues related to the management of severe acute malnutrition in infants and children, including in the context of HIV.
Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, base...d on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
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This regional technical guidance note was developed for the UNFPA Asia-Pacific Regional Office (APRO) and Asia-Pacific Country Offices to provide guidance on older persons, health workers, and caregivers in the contexts of COVID-19 to effectively support each member state and work with other partner...s in preparing for and responding to the COVID-19 epidemic.
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This article examines the activities of national and international actors in Pharmaceutical Services (PS) in Mozambique from 2007 to 2012, focusing on the public provision of HIV/Aids, malaria and tuberculosis medicines. It describes how PS functions in the country, what actors are involved in this ...area and the relations among them, pursuing salient issues in the modus operandi of partners in cooperation.
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Colombia is characterized by a fragile and prolonged humanitarian context marked by recurrent multi-hazards affecting its territories and combined with severe structural and systemic challenges within the health system. Recent shocks, including the
COVID-19 pandemic, growing violence within the Col...ombian territories and along the border with Venezuela (Bolivarian Republic of), and repetitive hydro-meteorological disasters over the last 12 months aggravate such chronic challenges.
In 2022, the number of people in need of humanitarian assistance increased by 300 000 due to deteriorating indicators of maternal and child mortality, pregnancy in adolescent girls, human immunodeficiency virus (HIV), suicides, sexually transmitted
infections (STIs), gender-based and sexual violence, and communicable diseases. increasing population trends, primarily due to mass migration movements and the persistence of armed conflicts, create access barriers to essential health services, mobility restrictions, and forced displacement, further impacting the health, lives, and well-being of populations in vulnerable situations. In many territories, geographical distance to health facilities and attacks against medical missions hinder providing appropriate healthcare.
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The 20th century was a period of unprecedented ecological change, with dramatic reductions in natural ecosystems and biodiversity and equally dramatic increases in people and domestic animals. Never before have so many animals been kept by so many people—and never before have so many opportunities... existed for pathogens to pass from wild and domestic animals through the biophysical environment to affect people causing zoonotic diseases or zoonoses. The result has been a worldwide increase in emerging zoonotic
diseases, outbreaks of epidemic zoonoses as well as a rise in foodborne zoonoses globally, and a troubling persistence of neglected zoonotic diseases in poor countries.
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This Clinic Supervisor’s Manual is helpful for focusing managers on the key elements of integrated primary health care as they simultaneously integrate new interventions for HIV/AIDS, tuberculosis, and malaria. This tool contains 12 sections. Section 1 explains how to use the manual. Section 2 hel...ps the clinic supervisors organize their supervisory visit. The remainder of the sections focus on a number of key areas during a clinic supervision visit.
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For 50 SAM children with medical complications and for a paediatric ward of 10-15 beds for 3 months
The PED/SAM kit is especially designed to provide medicines, renewables and equipment suitable for children and to treat the common childhood illness including severe acute malnutrition with medica...l complications.
This kit does NOT contain any food supplements, TB, HIV medicines or vaccines.
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Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, ...based on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health.
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The purpose of the landscape analysis is ultimately to facilitate improved engagement of private providers, thereby contributing to universal access to quality and affordable TB care and the end of the TB epidemic. It focuses on the role of private for-profit providers and on specific challenges and... experiences in engaging them for TB prevention and care.
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The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health care systems throughout the Region. Thou...gh there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
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Proper and dignified management of the dead in disasters is one of the three key pillars of humanitarian response and a fundamental factor in facilitating identification of the deceased and helping families discover the fate of their loved ones. This second and updated edition of this hugely success...ful manual provides practical and easy-to-follow guidelines on the recovery, documentation and storage of the remains of individuals who have died in disasters, helping first responders ensure that the dead are treated with respect and that information crucial for their subsequent identification is recorded. This revised edition incorporates experience gained in recent catastrophes, such as the 2013 Typhoon Haiyan in the Philippines, the 2014/15 Ebola epidemic in West Africa and the 2015 earthquake in Nepal.
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This report is not a country scorecard. Rather, its purpose is to act as a compass to guide progress towards health in the SDGs.
There has been a significant improvement in the state of health in the region with healthy life expectancy - time spent in full health - in the region increasing from 50....9 years to 53.8 between 2012 and 2015 - the most marked increase of any region in the world.
What is making Africans sick is changing. The top killers are still lower respiratory infections, HIV and diarrhoeal disease and countries have routinely focused on preventing and treating this trio, often through specialized programmes. The payoff has been significant declines in deaths due to these diseases. There has been a 50% reduction in the burden of disease caused by what have been the top 10 killers since 2000 and death rates have dropped from 87.7 to 51.1 deaths per 100,000 persons between 2000 and 2015...
Chronic diseases like heart disease and cancer are now claiming more lives with a person aged 30 to 70 in the region having a one in five chance of dying from a noncommunicable disease (NCDs).
Countries are specifically failing to provide essential services to two critical age groups – adolescents and the elderly...
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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Recognizing the extent to which the COVID-19 outbreaks affects women and men differently is hugely important. Some preliminary data suggested that more men than women are dying, potentially due to sex-based immunological differences, higher rates of cardiovascular disease for men and lifestyle choic...es, such as smoking. However, the experiences and lessons learned from the Zika and Ebola outbreaks and the HIV pandemic demonstrate that robust gender analysis and informed, gender-integrated response are vital to strengthen the access and acceptability of the humanitarian services needed to meet the distinct needs of women and girls, as well as men and boy and LGBTI people.
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In response to a call by the United Nations Secretary-General and the Governments of Guinea, Liberia and Sierra Leone, an international team conducted an Ebola Recovery Assessment.The aim was to contribute towards laying the foundation for short-, medium- and long-term recovery while the medical eme...rgency response continues to tackle the epidemic.
This summary report is based on a full report as well as three detailed reports submitted to each of the three governments as contributions to their national recovery planning processes.
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7. Rev Panam Salud Publica. 2020;44:e13
Haiti faces a double burden of disease. Infectious diseases continue to be an issue, while non-communicable diseases have become a significant burden of disease. More attention must also be focused on the increase in worrying public health issues such as road... injuries, exposure to forces of nature and HIV/AIDS in specific age groups. To address the burden of disease, sustained actions are needed to promote better health in Haiti and countries with similar challenges.
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Este artículo analiza un grupo particularmente vulnerable a la pandemia de la COVID-2019: las personas privadas de libertad (PPLs). Con base en el análisis del Censo Carcelario de 2019, presentamos la situación actual de las PPLs y las condiciones de los establecimient...os penitenciarios de Bolivia, con énfasis en los aspectos que impactan en la salud. Posteriormente, identificamos los principales factores estructurales detrás de la mayor vulnerabilidad epidemiológica y sanitaria de las PPLs, no solo a la COVID-2019, sino a epidemias en general. Diferentes instituciones involucradas en el combate de la pandemia desarrollaron recomendaciones para su prevención y tratamiento en contextos carcelarios. Considerando estas recomendaciones y los datos de la situación de las PPLs de Bolivia, desarrollamos propuestas de reformas políticas y legales para reducir la vulnerabilidad epidemiológica de esta población. Argumentamos que, mientras algunas son sencillas de implementar, muchas se enfrentan a obstáculos estructurales para su ejecución, demandando reformas profundas en la política carcelaria y el sistema penal.
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The National Strategic Plan is based on the following guiding principles:
1) Life-course approach: adolescence is a key decade in the course of life that influences the health outcomes later in life.
2) Comprehensive approach: It recognizes the cross cutting health and development needs o...f young people such as intentional and unintentional injuries and violence, SRH, HIV/AIDS, mental health, substance use, violence, substance use and substance use disorders, infectious diseases and common conditions.
3) Equity and rights-based approach: focusing on equitable access to services to all adolescents including vulnerable groups and the recognizing the need to move from aspirations to obligations in fulflling young people rights for the highest attainable standard of health.
4) Multisectoral approach: recognizing cognizant of the fact that holistic development of young people requires multisectoral approach involving education, social welfare.
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