Antimicrobial resistance (AMR) is a major public health challenge, which is recognized as high priority area by the Government of India. The increasing consumption of antibiotics is one of the key drivers of antimicrobial resistance seen in bugs of public health importance. Irrational prescription o...f broad-spectrum antibiotics, poor regulations around sale of antibiotics, self-medication, lack of education and awareness regarding responsible use of antibiotics have been identified as some of the key factors driving antimicrobial resistance in our country. The ‘National Health Policy’ (2017), addresses antimicrobial resistance as one of the key issues and prioritises development of guidelines regarding antibiotic use, limiting the over-the-counter use of antibiotics, restricting the use of antibiotics as growth promoters in livestock, and pharmaco-vigilance including prescription audit inclusive of antibiotic usage in the hospital and community.
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The purpose of this manual is to define a limited number of indicators that will objectively describe the management and use of antimicrobials in hospitals and to provide tools and step-by-step instructions for designing and carrying out an assessment of antibiotic use and management in hospitals. T...he indicators in this manual will complement the existing WHO (1993) indicators of outpatient antimicrobial use suggested in How to Investigate Drug Use in Health Facilities (including percentage of encounters in which an antibiotic was prescribed and percentage of medicine costs spent on antibiotics) and will address the need for antimicrobial indicators for inpatient conditions.
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The WHO CIA List should be used as a reference to help formulate and prioritize risk assessment and risk management strategies for containing antimicrobial resistance. The WHO CIA List supports strategies to mitigate the human health risks associated with antimicrobial use in ...food-producing animals and has been used by both public and private sector organizations. The list helps regulators and stakeholders know which types of antimicrobials used in animals present potentially higher risks to human populations and how use of antimicrobials might be managed to minimize antimicrobial resistance of medical importance. The use of the WHO CIA List, in conjunction with the OIE list of antimicrobials of veterinary importance (1) and the WHO Model Lists of Essential Medicines (2) , will allow for prioritization of risk management strategies in the human sector, the food animal sector, inagriculture (crops) and horticulture, through a coordinated multisectoral One Health approach.
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The focus of the current quarterly edition of Eurohealth (from the European Observatory on Health Systems and Policies) is Antimicrobial Resistance (AMR) and contains the following articles:
• Strengthening implementation of AMR national action plans
• Fostering clinical developmen...t and commercialisation of novel antibiotics
• Tackling AMR in the community
• Quantifying the benefits of vaccines in combating AMR
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This Tailoring Antimicrobial Resistance Programmes (TAP) process assists Member States in initiating and undertaking projects to address the spread of antimicrobial resistance (AMR) in their countries. AMR is a complex problem requiring unique, context-specific solutions. This TAP Toolbo...x contains a series of exercises and is aligned with the stages outlined in the TAP Quick Guide. The Toolbox is designed to be used by a TAP working group as they work through the stages outlined in the TAP Quick Guide. The exercises and tools presented in this Toolbox have been abridged and adapted from the TAP Manual which will be available soon.
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Report of the WHO/Bill & Melinda Gates Foundation Consultation. The Consultation was organized back-to-back with the first annual meeting of the International Coordinating Group of the BMGF-funded project for human and dog rabies elimination in developing countries, held at WHO headquarters, Geneva,... Switzerland, from 5 to 7 October 2009. This allowed the Consultation to benefit from the participation of the national coordinators and advisers of the BMGF-funded projects in the Philippines, South Africa (KwaZulu-Natal) and the United Republic of Tanzania
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Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where the disease is endemic, congenital CD (cCD...) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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Most neglected tropical diseases (NTDs) occur in remote areas of low- and middle-income countries, where health systems are often poorly developed. Therefore, these neglected patients generally lack access to quality preventive, diagnostic, and therapeutic care [1]. The difficulty to access NTD-ende...mic areas, challenging logistics, and the lack of skilled human resources in these areas are also major obstacles to conduct clinical research. We had to face these when conducting a good clinical practice/good clinical laboratory practice (GCP/GCLP)-compliant clinical study in eastern Sudan, a well-known endemic area for visceral leishmaniasis and other NTDs. We share here the challenges related to study preparation and implementation of this GCP/GCLP study that investigated the causes of persistent fever in a rural hospital located in Gedaref State in eastern Sudan. We think this type of paper may be of interest for researchers planning to conduct a clinical trial in a resource-limited setting as well as for funders of such research.
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Mycetoma is a chronic infectious disease of the subcutaneous tissue with a high morbidity. This disease has been reported from countries between 30°N and 15°S since 1840 but the exact burden of disease is not known. It is currently unknown what the incidence, prevalence and the number of reported ...cases per year per country is. In order to estimate what the global burden of mycetoma is, a meta-analysis was performed. In total 50 studies were included, which resulted in a total of 8763 mycetoma cases. Most cases were found in men between 11 and 40 years of age. The foot was most commonly affected.
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The objectives of the meeting were:
1. To step up the commitment of national authorities and technical and financial partners toWHO’s elimination objective for g-HAT.
2. To share achievements, challenges and views on the elimination goal among countries and implementing partners.
3. To assess t...he status of critical technical aspects to be solved in research and development of drugs and diagnostic tools, epidemiology, vector control and animal reservoirs.
4. To define the mechanisms for strengthening and organizing collaboration and coordination among stakeholders.
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TDR (Tropical Disease Research) Annual Report 2018
Schistosomiasis is widely recognized as a disease that is socially determined. An
understanding of the social and behavioural factors linked to disease transmission and
control should play a vital role in designing policies and strategies for schistosomiasis
prevention and control. To this must b...e added the awareness that schistosomiasis is
also a disease of poverty. It still survives in poverty-stricken, remote areas where there
is little or no safe water or sanitation, and health care is scarce or non-existent. For
a variety of complex reasons, many of which are addressed in this book, the disease
is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural
China. This concern for human behaviour in an environment of poverty echoes the
concerns of the new research priority for “diseases of poverty” identified by the
Special Programme for Research & Training in Tropical Diseases.
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Rabies is fatal, vaccine-preventable disease responsible for an estimated 59,000 human deaths each year. Most cases are transmitted by dogs, and most deaths occur in underserved populations in Africa and Asia. Approximately 40% of deaths occur in children.
Rabies is a disease of animals but too often the outcome is gauged in terms of human suffering and
death. Despite this, in areas of the world where rabies is endemic there is often a lack of communication between veterinary and medical professionals, to the extent that the disease continues to thri...ve and potential victims are not treated. The problem is partly
exacerbated by a lack of awareness and experience of the disease and of what to do when confronted by suspect cases. In these technologically advanced days, although it is possible to learn “all there is to know” about almost any subject, it is sometimes difficult to distil the essence.
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A group of enzootic and zoonotic protozoan infections, the leishmaniases constitute among the most severely neglected tropical diseases (NTDs) and are found in all continents except Oceania. Representing the most common infectious diseases, NTDs comprise an open-ended list of some 20 parasitic, bact...erial, viral, protozoan and helminthic infections. Called “diseases of the poor,” because of their characteristic prevalence in poor populations regardless of a country's income status, they infect over one billion people in over 140 countries, with about 90% of the global burden in Africa. While NTDs do not contribute significantly to global deaths, they are debilitating and remain the most common infections among the poor worldwide, preventing them from escaping poverty by impacting livelihoods such as agriculture and livestock, and affecting cognitive, developmental and education outcomes.
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The European Union Agency for Fundamental Rights (FRA) collected evidence through field missions and from other sources reporting on the situation in March, May and October 2022.
In parallel, it launched a large-scale online survey of those fleeing Ukraine. This aimed to gather personal experiences... of their journey to, arrival in and settling in the EU. The survey covered displaced people, including many children, in the 10 EU Member States hosting large numbers of people registered for temporary protection.
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To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to u...se its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
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Improving the survival chances and quality of life of women, newborns, and children remains an urgent global challenge. Since 2012, substantial progress has been made in reducing maternal and under-5 deaths, and a only handful of countries are on target to meet the SDG targets in 2030. Yet, 5 millio...n children still die each year under the age of 5, and nearly half of those are newborns less than a month old. Worse still, the global maternal mortality ratio is going in the wrong direction.
A Decade of Progress and Action for the Future will examine the tenacity and innovation that helped us make gains, the lessons learned through monitoring, country-led adaptation and leadership, analysis, and reflection, as well as the approaches we must take to reinvigorate the momentum and global commitment to improving maternal and child survival. Increasing coverage, strengthening the quality of care, and enhancing equity will be tantamount to our global progress.
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The annual Joint Meeting of the Food and Agriculture Organization of the United Nations (FAO) Panel of Experts on Pesticide Residues in Food and the Environment and the World Health Organization (WHO) Core Assessment Group on Pesticide Residues (JMPR) was held in Rome, Italy, from 13 to 22 September.... The FAO panel of experts had met in preparatory sessions from 8 to 12 September. The Meeting was held in pursuance of recommendations made by previous Meetings and accepted by the governing bodies of FAO and WHO that studies should be undertaken jointly by experts to evaluate possible hazards to humans arising from the occurrence of pesticide residues in foods. During the meeting the FAO Panel of Experts was responsible for reviewing pesticide use patterns (use of good agricultural practices), data on the chemistry and composition of the pesticides and methods of analysis for pesticide residues and for estimating the maximum residue levels that might occur as a result of the use of the pesticides according to good agricultural use practices. The WHO Core Assessment Group was responsible for reviewing toxicological and related data and for estimating, where possible and appropriate, acceptable daily intakes (ADIs) and acute reference doses (ARfDs) of the pesticides for humans. This report contains information on ADIs, ARfDs, maximum residue levels, and general principles for the evaluation of pesticides. The recommendations of the Joint Meeting, including further research and information, are proposed for use by Member governments of the respective agencies and other interested parties.
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The WHO Living guideline: Drugs to prevent COVID-19 contains the Organization’s most up-to-date recommendations for the use of drugs to prevent COVID-19. The latest version of this living guideline is available in pdf format (via the ‘Download’ button) and via an online platform.
Guidelines ...regarding the use of drugs to treat (rather than prevent) COVID-19 are included in a separate WHO document, Therapeutics and COVID-19: living guideline, that can via an online platform and in pdf format (or click ‘PDF’ in top right corner of online platform). Guidelines regarding the clinical management of COVID-19 patients are included in a further document, COVID-19 Clinical management: Living guideline, that can be accessed via an online platform and in pdf format (or click ‘PDF’ in top right corner of online platform).
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