Q7. SCOPING QUESTION: In adults with moderate-severe depressive disorder, what is the effectiveness and safety of antidepressant medication (ADM) in comparison with psychological treatment?
The WHO mhGAP programme’s existing guidelines recommend that either structured brief psychological treatm...ents (e.g., interpersonal psychotherapy or cognitive behavioural therapy, including behavioural activation) or antidepressant medication (e.g., SSRIsi and tricyclic antidepressants) be considered in adults with moderate-severe depression. Health care workers need to know whether these treatments have different effects, including side-effects, in treating depressive disorder in the short and long term, in order to improve clinical decision-making.
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Vector-borne diseases are responsible for 17% of the global burden of communicable diseases and more than 500 000 deaths annually. The ambitious global targets for the control of vector-borne diseases come in the context of the (re-)emergence of diseases, increasing resistances to insecticides and u...ncertainty related to the financing of global vector control efforts. The United Nations 2030 Agenda with its related Sustainable Development Goals (SDGs), the New Urban Agenda adopted at the United Nations Conference on Housing and Sustainable Urban Development (Habitat III)
in Quito in 2016 and WHO’s Global vector control response 2017–2030 (WHO, 2017a) emphasize the value of elevating multisectoral actions and strategies that extend beyond the health sector to the core of integrated vector control.
This policy brief underlines the important role housing conditions have in the transmission of vector-borne diseases and showcases interventions and policies the housing sector can contribute to effective, integrated and intersectoral vector-borne diseases management.
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The World health statistics report is the annual compilation of health and health-related indicators which has been published by the World Health Organization (WHO) since 2005. The 2023 edition reviews more than 50 health-related indicators from the Sustainable Development Goals (SDGs) and WHO’s T...hirteenth General Programme of Work (GPW 13).
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The content of these guidelines goes beyond the technicalities of medical needs with additional insights into community empowerment, possible access to welfare and economic opportunities and similar issues. If these are adequately explored, the health and quality of life of people affected and their... families would be greatly restored.
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This publication describes the first WHO public-benefit Target Product Profiles (TPPs) for snakebite antivenoms. It focuses on antivenoms for treatment of snakebite envenoming in sub-Saharan Africa. Four TPPs are described in the document:
Broad spectrum Pan-African polyvalent antivenoms: products ...that are intended for widespread utility throughout sub-Saharan Africa for treatment of envenoming irrespective of the species of snake causing a bite. Monovalent antivenoms for specific use cases: for products for a single species (or genus) of snake (e.g., boomslangs or carpet viper antivenoms).
Syndromic Pan-African polyvalent antivenoms for neurotoxic envenoming: products that are intended for treatment of envenoming by species whose venoms are neurotoxic. Syndromic Pan-African polyvalent antivenoms for non-neurotoxic envenoming: products for snakebite envenoming where the effects are largely haemorrhagic, necrotic or procoagulant.
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There is growing international consensus that food systems transformation is important to address the challenges of malnutrition in all its forms, the burden of noncommunicable diseases (NCDs), environmental sustainability, increasing inequality and ensuring the welfare of workers and animals. In li...ght of the urgency of these challenges, there are questions about the role of red and processed meat in healthy and sustainable food systems. Globally, production and consumption of all types of meat has increased substantially in the last 50 years, and – although red meat consumption is now plateauing in high-income countries (HICs) – is predicted to increase by a further 50% by 2050. Meat consumption remains highly unequal both between and within countries, and animal-source food intakes, including red meat, are lowest among those at most risk of undernutrition
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Dieser Bericht enthält eine neue Strategie für Investitionen in die Gesundheit als Beitrag zur Wirtschaftsentwicklung, vor allem in den ärmsten Ländern der Welt, auf der Grundlage einer neuen globalen Partnerschaft zwischen sich entwickelnden und entwickelten Ländern. Zügiges und mutiges Hande...ln könnte zum Ende dieser Dekade mindestens 8 Millionen
Menschenleben pro Jahr retten, die Lebensdauer und die Leistungsfähigkeit der Armen erhöhen und ihre wirtschaftliche Lage verbessern Hierfür wären zwei wichtige Initiativen zu ergreifen: eine deutliche Erhöhung der Mittel, die für Gesundheit ausgegeben werden,sowohl durch die armen Länder als auch durch die Geber und eine Beseitigung der nichtfinanziellen Hindernisse, die arme Länder in ihrer Fähigkeit zur Bereitstellung von Gesundheitsdiensten einschränken
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The increasing amounts of official development assistance (ODA) for health have been aimed primarily at fighting HIV/AIDS, malaria and tuberculosis. Neglected tropical diseases (NTD), one of the most serious public health burdens among the most deprived communities, have only recently drawn the atte...ntion of major donors. While frequently stated, the low share
of funding for NTD control projects has not been calculated empirically. Our analysis of ODA commitments for infectious disease control for the years 2003 to 2007 confirms that Development Assistance Committee (DAC)-countries and multilateral donors have largely ignored funding NTD control projects. On average, only 0.6% of total annual health ODA was dedicated
to the fight against NTDs while the average share of control projects for HIV/AIDS was 36.3%, for malaria 3.6%, and for tuberculosis 2.2%. This allocation of health ODA does not reflect the diseases’ respective health burdens.
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The majority of Countdown countries did not reach the fourth Millennium Development Goal (MDG 4) on reducing child mortality, despite the fact that donor funding to the health sector has drastically increased. When tracking aid invested in child survival, previous studies have exclusively focused on... aid targeting reproductive, maternal, newborn, and child health (RMNCH). We take a multi-sectoral approach and extend the estimation to the four sectors that determine child survival: health (RMNCH and non-RMNCH), education, water and sanitation, and food and humanitarian assistance (Food/HA). Methods and findings: Using donor reported data, obtained mainly from the OECD Creditor Reporting System and Development Assistance Committee, we tracked the level and trends of aid (in grants or loans) disbursed to each of the four sectors at the global, regional, and country levels. We performed detailed analyses on missing data and conducted imputation with various methods. To identify aid projects for RMNCH, we developed an identification strategy that combined keyword searches and manual coding. To quantify aid for RMNCH in projects with multiple purposes, we adopted an integrated approach and produced the lower and upper bounds of estimates for RMNCH, so as to avoid making assumptions or using weak evidence for allocation. We checked the sensitivity of trends to the estimation methods and compared our estimates to that produced by other studies. Our study yielded time-series and recipient-specific annual estimates of aid disbursed to each sector, as well as their lower- and upper-bounds in 134 countries between 2000 and 2014, with a specific focus on Countdown countries. We found that the upper-bound estimates of total aid disbursed to the four sectors in 134 countries rose from US$ 22.62 billion in 2000 to US$ 59.29 billion in
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Background: In 2015, 5.3 million babies died in the third trimester of pregnancy and first month following birth. Progress in reducing neonatal mortality and stillbirth rates has lagged behind the substantial progress in reducing postneonatal and maternal mortality rates. The benefits to prenatal an...d neonatal health (PNH) from maternal and child health investments cannot be assumed. Methods: We analysed donor funding for PNH over the period 2003–2013. We used an exhaustive key term search followed by manual review and classification to identify official development assistance and private grant (ODA+) disbursement records in the Countdown to 2015 ODA+ Database.
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While there has been real progress in addressing the burden of disease in the WHO African region, the COVID-19 pandemic has highlighted the link between health, economics and security, as the region saw decades of progress threatened, including positive trends in decreasing inequality. In the Africa...n Region the momentum towards achieving the 2030 SDG disease burden reduction targets (SDG targets 3.3, 3.4 and 3B) has stalled.
The COVID-19 pandemic was also a major threat to gains made, such as the eradication of polio in the region, declared in 2020; reduced numbers of new HIV infections in 2021 compared to 2010; and passing the 2020 milestone of the End TB Strategy, with a 22% reduction in new cases compared with 2015. However, the pandemic also disrupted essential health services in 92% of countries globally, 22.7 million children missed basic immunization, there was an increase in malaria and TB, and global deaths from TB rose for the first time since 2015.
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Four initiatives have estimated the value of aid for reproductive, maternal, newborn, and child health
(RMNCH): Countdown to 2015, the Institute for Health Metrics and Evaluation (IHME), the Muskoka Initiative, and
the Organisation for Economic Co-operation and Development (OECD) policy marker. We... aimed to compare the
estimates, trends, and methodologies of these initiatives and make recommendations for future aid tracking.
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Donor financing to low- and middle-income countries for reproductive, maternal, newborn, and child health increased substantially from 2008 to 2013. However, increased spending by donors might not improve outcomes, if funds are delivered in ways that undermine countries’ public financial managemen...t systems and incur high transaction costs for project implementation
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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Air pollution is a major environmental risk factor and contributor to chronic, noncommunicable diseases (NCDs). However, most public health approaches to NCD prevention focus on behavioural and biomedical risk factors, rather than environmental risk factors such as air pollution. This article discus...ses the implications of such a focus. It then outlines the opportunities for those in public health and environmental science to work together across three key areas to address air pollution, NCDs and climate change: (a) acknowledging the shared drivers, including corporate determinants; (b) taking a ‘co-benefits’ approach to NCD prevention; and (c) expanding prevention research and evaluation methods through investing in systems thinking and intersectoral, cross-disciplinary collaborations.
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The Global Status Report on Noncommunicable Diseases (NCDs) 2014 by the World Health Organization outlines the global impact of NCDs, including cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, which are responsible for a significant portion of global mortality, particular...ly in low- and middle-income countries.
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This global status report on prevention and control of NCDs (2014), is framed around the nine voluntary global targets. The report provides data on the current situation, identifying bottlenecks as well as opportunities and priority actions for attaining the targets. The 2010 baseline estimates on N...CD mortality and risk factors are provided so that countries can report on progress, starting in 2015. In addition, the report also provides the latest available estimates on NCD mortality (2012) and risk factors, 2010-2012.All ministries of health need to set national NCD targets and lead the development and implementation of policies and interventions to attain them. There is no single pathway to attain NCD targets that fits all countries, as they are at different points in their progress in the prevention and control of NCDs and at different levels of socioeconomic development. However all countries can benefit from the comprehensive response to attaining the voluntary global targets presented in this report.
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The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma and Allergies in Childhood (ISAAC) and The International Union Against Tuberculosis and Lung Disease (T...he Union) to monitor asthma and improve asthma care, particularly in low- and middle-income countries (LMICs).
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid...ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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