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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc
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e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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Clinical Microbiology and Infection Volume 21, Issue 5, May 2015, Pages 433-443;
The neglected zoonotic diseases (NZDs) have been all but eradicated in wealthier countries, but remain major causes of ill-health and mortality across Africa, Asia, and Latin America. This neglect is, in part, a conse
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quence of under-reporting, resulting in an underestimation of their global burden that downgrades their relevance to policy-makers and funding agencies. Increasing awareness about the causes of NZDs and how they can be prevented could reduce the incidence of many endemic zoonoses.
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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
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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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The new review paper, The Impacts of Climate Change on Health, identifies the extent to which increasing emissions, extreme weather and temperatures elevate health risks, from infectious disease to malnutrition, and assesses the associated health burden. It concludes that the health burden will exce
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ed the level of demand that health systems are prepared for.
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Current evidence that the climate is changing is overwhelming. Impacts of climate change and variability are being observed: more intense heat-waves, fires and floods; and increased prevalence of food- water- and vector-borne diseases. Climate change will put pressure on environmental and health det
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erminants, such as food safety, air pollution and water quantity and quality. A climate-resilient future depends fundamentally on reducing greenhouse gas emissions. Limiting warming to below 2 °C requires transformational technological, institutional, political and behavioural changes: the foundations for this are laid out in the Paris Agreement of December 2015. The health sector can lead by example, shifting to environmentally friendly practices and minimizing its carbon emissions. A climate-resilient future will increasingly depend on managing and reducing climate change risks to protect health. In the near term, this can be enhanced by including climate change in national health programming and creating climate-resilient health systems.
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The main message emerging from this new comprehensive global assessment is that premature death and disease can be prevented through healthier environments – and to a significant degree. Analysing the latest data on the environment-disease nexus and the devastating impact of environmental hazards
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and risks on global health, backed up by expert opinion, this report covers more than 100 diseases and injuries.
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his sequel to the Groundswell report includes projections and analysis of internal climate migration for three new regions: East Asia and the Pacific, North Africa, and Eastern Europe and Central Asia. Qualitative analyses of climate-related mobility in countries of the Mashreq and in Small Island D
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eveloping States (SIDS) are also provided. This new report builds on the scenario-based modeling approach of the previous Groundswell report from 2018, which covered Sub-Saharan Africa, South Asia, and Latin America. The two reports’ combined findings provide, for the first time, a global picture of the potential scale of internal climate migration across the six regions, allowing for a better understanding of how slow-onset climate change impacts, population dynamics, and development contexts shape mobility trends.
Available in English, French, Arabic, Spanish
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Les messages clés pour des actions concrètes présentés ci-après résument un
ensemble de chapitres sur différents problèmes de santé liés à l’environnement,
qui peuvent être consultés à l’adresse suivante: www.who.int/ceh/publications/
healthyenvironmentsforhealthychildren.
The World Climate and Security Report 2021
Brock, S.; Barrett, O.L.; Birkman, L.; et al.
International Military Council on Climate and Security
(2021)
CC
The World Climate and Security Report (WCSR) 2021 from the Expert Group of the International
Military Council on Climate and Security is a global assessment of the security dimensions of a changing
climate and effective means to address them. It is intended to inform timely climate and security po
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licy
and action, and builds upon the analysis in the first WCSR, released in February 2020.
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The World Climate and Security Report 2021_2
Brock, S.; Barrett, O.L.; Birkman, L.; et al.
International Military Council on Climate and Security
(2021)
C1
The World Climate and Security Report (WCSR) 2021 from the Expert Group of the International Military Council on Climate and Security is a global assessment of the security dimensions of a changing climate and effective means to address them. It is intended to inform timely climate and security poli
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cy and action, and builds upon the analysis in the first WCSR, released in February 2020.
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The biosphere underlies the whole sustainable development concept, as the layer on
which society and the economy rely. Nature and biodiversity fuel the natural cycles
and life-support systems of the planet, on which humanity ultimately depends.
Surveillance of antimicrobial resistance in Europe 2020 data: executive summary
Lancet Planet Health 2020; 4: e271–79
The global burden of disease associated with air pollution exposure exacts a massive toll on human health worldwide: exposure to air pollution is estimated to cause millions of deaths and lost years of healthy life annually. The burden of disease attributable to air pollution is now estimated to be
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on a par with other major global health risks such as unhealthy diet and tobacco smoking, and air pollution is now recognized as the single biggest environmental threat to human health.
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Children without access to safe water are more likely to die in infancy -- and throughout childhood -- from diseases caused by
water-borne bacteria, to which their small bodies are more vulnerable.
This report, which involved input from across WaterAid, in particular from the Programme Support Unit (PSU) of WaterAid UK, includes case studies from a variety of countries, including Bangladesh, Burkina Faso, Eswatini, Ethiopia, Ghana, India and Nepal, each demonstrating what must be done now to i
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mprove WASH services and address current challenges, in order to increase community resilience to climate change.
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Biodiversity and Health in the Face of Climate Change pp 47–66
This chapter reviews the emerging importance of pollen allergies in relation to ongoing climate change. Allergic diseases have been increasing in prevalence over the last decades, partly as the result of the impact of climate change.
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Increased sensitisation rates and more severe symptoms have been the partial outcome of: increased pollen production of wind-pollinated plants resulting in long-term increased abundance of pollen in the air we breathe; earlier shifts of airborne pollen seasons making occurrence of allergic symptoms harder to predict and deal with efficiently; increased allergenicity of pollen causing more severe health effects in allergic individuals; introduction of new, invasive allergenic plant species causing new sensitisations; environment-environment interactions, such as plants and hosted microorganisms, i.e. fungi and bacteria, which comprise a complex and dynamic system, with additive, presently unforeseeable influences on human health; environment-human interactions, as the consequence of a combination of environmental factors, like air pollution, global warming, urbanisation and microclimatic variability, which create a multi-resolution spatiotemporal system that requires new processing technologies and huge data inflow in order to be thoroughly investigated. We suggest that novel, real-time, personalised pollen information services, like mobile-app risk alerts, must be developed to provide the optimum first line of allergy management.
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BackgroundClimate change is one of the great challenges of our time. The consequences of climate change on exposed biological subjects, as well as on vulnerable societies, are a concern for the entire scientific community. Rising temperatures, heat waves, floods, tornadoes, hurricanes, droughts, fir
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es, loss of forest, and glaciers, along with disappearance of rivers and desertification, can directly and indirectly cause human pathologies that are physical and mental.
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