Lorsqu’un virus circule largement dans une population et entraîne de nombreuses infections, la probabilité de mutation augmente. Plus un virus a de possibilités de se propager, plus il se réplique – et plus il est susceptible de muter. L’arrêt de la propagation du virus à la source res...te essentiel. Les mesures actuelles visant à réduire la transmission du virus – dont le lavage fréquent des mains, le port du masque, la distanciation physique et le fait d’éviter de se rendre dans les lieux très fréquentés ou fermés – restent efficaces contre les nouveaux variants car elles réduisent la transmission du virus, qui a donc moins de possibilités de muter. Grâce aux notes explicatives de l’OMS sur les vaccins, en savoir plus sur les vaccins, sur leur fonctionnement et sur la façon dont ils sont fabriqués pour en garantir l’innocuité et y permettre un accès équitable.
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Le flyer „MMV Strategy“ présente la stratégie de la Medicines for Malaria Venture (MMV) pour lutter contre le paludisme. Il met en avant les objectifs clés de l'organisation, qui se concentre sur la recherche et le développement de nouveaux médicaments antipaludiques. Le document décrit le...s efforts pour améliorer l'accès aux traitements de qualité, soutenir les partenariats mondiaux, et accélérer l'innovation dans la lutte contre le paludisme, avec un accent particulier sur les populations à risque élevé.
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L’année 2024 a été particulièrement éprouvante pour les enfants. Face à l’intensification des conflits violents, des chocs climatiques et de la pauvreté, leurs besoins n’ont en effet cessé de croître tandis que les ressources disponibles pour y répondre ont continué de diminuer.
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Comme le montre notre Rapport annuel, l’UNICEF a néanmoins été présent dans plus de 190 pays et territoires, sauvant et améliorant la vie de millions d’enfants, y compris dans les endroits les plus difficiles d’accès. Avec l’aide de nos partenaires, nous avons œuvré à fournir de l’eau salubre et des installations d’assainissement, ainsi que des services de protection, de soutien psychosocial, de santé, de nutrition, de vaccination, d’éducation et de développement des compétences.
Alors que 2025 s’ouvre dans un contexte d'instabilité persistante, de bouleversements politiques, d'incertitude économique et de multiplication des crises humanitaires, l’organisation doit plus que jamais donner le meilleur d’elle-même. Or, les coupes annoncées et attendues dans les financements de l’aide internationale limitent notre capacité à venir en aide aux millions d’enfants les plus vulnérables.
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Le Plan Stratégique National de Lutte contre le Paludisme 2023–2026 du Togo définit les grandes orientations pour réduire de 65 % l’incidence et la mortalité liées au paludisme d’ici 2026, en comparaison avec les niveaux de 2022. Élaboré par le Programme National de Lutte contre le Pa...ludisme (PNLP), il s’inscrit pleinement dans les objectifs mondiaux fixés par l’Organisation mondiale de la Santé pour parvenir à l’élimination du paludisme d’ici 2030. Ce plan repose sur quatre axes stratégiques : la prévention à travers l’utilisation des moustiquaires imprégnées, la chimio-prévention et la lutte antivectorielle ; la prise en charge efficace des cas grâce au diagnostic rapide et au traitement par ACT ; le renforcement du système de santé et la gestion du programme ; ainsi que la surveillance, le suivi et l’évaluation des interventions. Une attention particulière est accordée à la digitalisation des outils, à l’amélioration de la qualité des données, à l’implication des communautés locales et à la réduction des inégalités régionales dans l’accès aux services. Intégrant les partenaires techniques et financiers, le secteur privé et les acteurs communautaires, ce document constitue une véritable feuille de route nationale pour coordonner et intensifier la lutte contre le paludisme sur la période 2023–2026.
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Le Plan Stratégique National de Lutte contre le Paludisme 2023–2027 de la Guinée vise à réduire de 80 % l’incidence et la mortalité liées au paludisme d’ici 2027, en s’appuyant sur les leçons des années précédentes. Il prévoit des actions renforcées de prévention (moustiquaire...s, lutte antivectorielle, chimio-prévention saisonnière, prévention chez les femmes enceintes et les enfants), une amélioration de la prise en charge des cas à tous les niveaux (public, privé, communautaire), ainsi qu’un renforcement de la gestion, des ressources, de la gouvernance, de la communication et de l’évaluation. L’objectif final est de guider le pays vers la pré-élimination du paludisme, en assurant l’accès universel à des soins de qualité et en mobilisant tous les acteurs nationaux et internationaux.
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Le Plan Stratégique National de Lutte contre le Paludisme au Cameroun 2019–2023 vise à réduire l’incidence et la mortalité liées au paludisme dans tout le pays, en mettant l’accent sur les groupes les plus vulnérables comme les enfants de moins de 5 ans et les femmes enceintes. Il repose... sur des interventions de prévention (moustiquaires imprégnées, pulvérisation intradomiciliaire, chimioprévention saisonnière), un accès universel au diagnostic rapide et au traitement efficace, ainsi qu’un renforcement de la gouvernance, du système de santé, de la surveillance épidémiologique et de la communication pour le changement de comportement. Le plan s’inscrit dans la continuité des stratégies nationales et internationales, avec une approche participative impliquant les autorités nationales, les partenaires techniques et financiers, les communautés locales et le secteur privé.
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Le Plan d'action régional pour la vaccination dans les Amériques (RIAP) constitue une étape fondamentale pour consolider les progrès accomplis et offre une vision concrète pour relever les défis actuels et futurs en vue d'atteindre les objectifs fixés pour l'année 2030. Ce plan est essentiel... pour renforcer les systèmes de santé, améliorer l'accès à la vaccination et optimiser la coordination entre les parties prenantes, en veillant à ce que tous les secteurs de la population aient la possibilité de bénéficier de programmes de vaccination résilients, efficaces et équitables tout au long du parcours de vie. Conçu dans le cadre stratégique de la politique pour la Revitalisation de la vaccination en tant que bien de santé publique pour une santé universelle et aligné sur le Programme pour la vaccination à l’horizon 2030, le plan d’action synthétise les priorités déterminées par les pays et les territoires, en utilisant des indicateurs qui ciblent six axes stratégiques d’intervention : la gouvernance, la surveillance, l'intégration, la communication, les ressources humaines et la prise de décision fondée sur des données probantes. Cette approche globale et inclusive réaffirme la volonté de parvenir à la couverture sanitaire universelle et d'atteindre les objectifs de développement durable. À l'avenir, il sera essentiel de maintenir un engagement fort à tous les niveaux en adaptant les stratégies aux changements que connaîtront les pays et les territoires, afin de faire progresser efficacement leurs efforts de vaccination par la mise en œuvre de meilleures pratiques et d’approches novatrices. Toutes les parties prenantes sont encouragées à participer à cet effort collectif pour que la vaccination soit considérée comme un bien public et que la population soit protégée contre les maladies évitables par la vaccination.
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in ...health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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This publication presents the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda). The Agenda is a call to action to the health sector to lead the charge to address environmental determinants of health in the Americas. The Pan American Health Organization (PAH...O) will work with Member States to achieve its goal and objective to ensure healthy lives and promote well-being for all at all ages using a sustainable and equitable approach that places a priority on reducing health inequity. The Agenda has been developed under the umbrella of the WHO Global Strategy on Health, Environment, and Climate Change, and builds upon the commitments set forth in the Sustainable Health Agenda for the Americas 2018–2030 and the PAHO Strategic Plan 2020–2025. The Agenda was developed in consultation with the Technical Advisory Group and through a consensus-driven decision-making process with Member States during the 2019–2020 period. Looking toward the achievement of Sustainable Development Goal 3, the Agenda focuses on: improving the performance of environmental public health programs and institutions; fostering environmentally resilient and sustainable health systems; and promoting environmentally healthy and resilient cities and communities. Its implementation will be context-specific, based on the needs and realities of the countries. It will benefit countries and territories by promoting good governance practices, strengthening the leadership and coordination roles of the health sector, fostering cross-sectoral action, focusing on primary prevention, and enhancing evidence and communication. It will facilitate access to human, technical, and financial resources necessary to address environmental determinants of health and ensure that the Region is fully engaged in global health, environment, and climate change processes and agreements. The objective of the Agenda is to strengthen the capacity of health actors in the health and non-health sectors to address and adapt to environmental determinants of health (EDHs), prioritizing populations living in conditions of vulnerability, in order to meet Outcome 18 of the PAHO Strategic Plan 2020–2025 directly and several other outcomes of the Plan indirectly. To address and adapt to the challenges of EDHs in the Region, an integrated and evidence-informed approach within the health sector and across sectors will be needed, one enabled, and supported by good governance practices, adequate management mechanisms, high-level political will, and adequate human, technical, technological, and financial resources.
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The burden of diabetes is high and increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of overweight/obesity and unhealthy lifestyles. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over... 134 million by 2045. Approximately 57% of these individuals remain undiagnosed. Type 2 diabetes, which accounts for majority of the cases, can lead to multiorgan complications, broadly divided into microvascular and macrovascular complications. These complications are a significant cause for increased premature morbidity and mortality among individuals with diabetes, leading to reduced life expectancy and financial and other costs of diabetes leading to profound economic burden on the Indian health care system. The risk for diabetes is largely influence by ethnicity, age, obesity and physical inactivity, unhealthy diet, and behavioral habits in addition to genetics and family history. Good control of blood sugar blood pressure and blood lipid levels can prevent and/or delay the onset of diabetes complications. The prevention and management of diabetes and associated complications is a huge challenge in India due to several issues and barriers, including lack of multisectoral approach, surveillance data, awareness regarding diabetes, its risk factors and complications, access to health care settings, access to affordable medicines, etc. Thus, effective health promotion and primary prevention, at both, individual and population levels are the need of the hour to curb the diabetes epidemic and reduce diabetes-related complications in India
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KEY MESSAGES
Always talk to a GBV specialist first to understand what GBV services are available in your area. Some services may take the form of hotlines, a mobile app or other remote support.
Be aware of any other available services in your area. Identify services provided by humanitarian pa...rtners such as health, psychosocial support, shelter and non-food items. Consider services provided by communities such as mosques/ churches, women’s groups and Disability Service Organizations.
Remember your role. Provide a listening ear, free of judgment. Provide accurate, up-to-date information on available services. Let the survivor make their own choices. Know what you can and cannot manage. Even without a GBV actor in your area, there may be other partners, such as a child protection or mental health specialist, who can support survivors that require additional attention and support. Ask the survivor for permission before connecting them to anyone else. Do not force the survivor if s/he says no.
Do not proactively identify or seek out GBV survivors. Be available in case someone asks for support.
Remember your mandate. All humanitarian practitioners are mandated to provide non-judgmental and non-discriminatory support to people in need regardless of: gender, sexual orientation, gender identity, marital status, disability status, age, ethnicity/tribe/race/religion, who perpetrated/committed violence, and the situation in which violence was committed. Use a survivor-centered approach by practicing:
Respect: all actions you take are guided by respect for the survivor’s choices, wishes, rights and dignity.
Safety: the safety of the survivor is the number one priority.
Confidentiality: people have the right to choose to whom they will or will not tell their story. Maintaining confidentiality means not sharing any information to anyone.
Non-discrimination: providing equal and fair treatment to anyone in need of support.
If health services exist, always provide information on what is available. Share what you know, and most importantly explain what you do not. Let the survivor decide if s/he wants to access them. Receiving quality medical care within 72 hours can prevent transmission of sexually transmitted infections (STIs), and within 120 hours can prevent unwanted pregnancy.
Provide the opportunity for people with disabilities to communicate to you without the presence of their caregiver, if wished and does not endanger or create tension in that relationship.
If a man or boy is raped it does not mean he is gay or bisexual. Gender-based violence is based on power, not someone’s sexuality.
Sexual and gender minorities are often at increased risk of harm and violence due to their sexual orientation and/or gender identity. Actively listen and seek to support all survivors.
Anyone can commit an act of gender-based violence including a spouse, intimate partner, family member, caregiver, in-law, stranger, parent or someone who is exchanging money or goods for a sexual act.
Anyone can be a survivor of gender-based violence – this includes, but isn’t limited to, people who are married, elderly individuals or people who engage in sex work.
Protect the identity and safety of a survivor. Do not write down, take pictures or verbally share any personal/identifying information about a survivor or their experience, including with your supervisor. Put phones and computers away to avoid concern that a survivor’s voice is being recorded.
Personal/identifying information includes the survivor’s name, perpetrator(s) name, date of birth, registration number, home address, work address, location where their children go to school, the exact time and place the incident took place etc.
Share general, non-identifying information
To your team or sector partners in an effort to make your program safer.
To your support network when seeking self-care and encouragement.
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New E-learning on health care responsibilities in times of conflict
Are you a doctor wondering how to interact with the media, or a nurse wondering how to treat patient information in difficult circumstances? Are you an ambulance driver unsure of what your responsibilities are? Are you a hospital a...dministrator wondering what to do with overwhelming numbers of deceased patients? If so, the Health Care in Danger project's new e-learning module on the responsibilities of health-care personnel is for you.
The module introduces health-care personnel to the principles underpinning ethical considerations when working in conflict situations and other emergencies. Using an engaging multimedia interface, the module presents various dilemmas that medical personnel face every day. Users can explore these issues in depth by interacting virtually with experts in the field, studying real-life issues, and receiving guidance that helps them to make decisions in difficult situations. The module allows learners freedom to explore, and for each chapter includes documents with more detailed information on topics of interest to the user.
Access is completely free, and no login is required. The module functions on Safari, Internet Explorer 9 and later, Firefox, and Google Chrome, as well as on tablet devices. Would you like to get started? The module is available online, and hosted by ICRC.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa...ctors (microbial exposure, exposure to passive smoking and air pollution), seemed to contribute to this trend. The increased prevalence observed in metropolitan areas with respect to rural ones and, overall, in industrialized countries, highlighted the role of air pollution in asthma inception. Asthma accounts for 1.1% of the overall global estimate of “Disability-adjusted life years” (DALYs)/100,000 for all causes. Mortality in children is low and it decreased across Europe over recent years. Children from LMICs particularly suffer a disproportionately higher burden in terms of morbidity and mortality. Global asthma-related costs are high and are usually are classified into direct, indirect and intangible costs. Direct costs account for 50–80% of the total costs. Asthma is one of the main causes of hospitalization which are particularly common in children aged < 5 years with a prevalence that has been increased during the last two decades, mostly in LMICs. Indirect costs are usually higher than in older patients, including both school and work-related losses. Intangible costs are unquantifiable, since they are related to impairment of quality of life, limitation of physical activities and study performance. The implementation of strategies aimed at early detect asthma thus providing access to the proper treatment has been shown to effectively reduce the burden of the disease.
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It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t...he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency.
Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls.
An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is:
A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes).
An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa.
The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions.
Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward.
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Under the theme “Stronger Together”, the campaign aims to offer information and strategies to assist communities in the region in better coping with the psychological impact of adverse events before, during and after a disaster situation. It also aims to raise awareness to reduce the stigma abou...t seeking mental health and psychosocial support.
You can download a wide range of communication material: videos, posters, radio jingles, guidebooks.
The Caribbean is highly prone to natural hazards, including seismic activity, hurricanes, landslides and floods. These events have resulted in lost lives, serious injuries and severe damage to housing and infrastructure. A single hurricane event can affect more than one island, and completely erase the gains of many years of productivity. As a result, these unpredictable hazards create disruption and have an ongoing impact on people’s lives - affecting their mental health and psychosocial well-being.
Although everyone is affected in some way by disaster events, there are a wide range of reactions and feelings that a person can experience. People may feel overwhelmed, confused or very uncertain about what is happening. They can also feel very fearful, anxious, numb or detached. People who feel safe, connected, calm and hopeful, have access to social, physical and emotional support and find ways to help themselves after a disaster, however, will be better able to recover long-term from mental health effects
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Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Mpox continues to affect people around the world. A new framework released today by WHO will guide health authorities, communities and other stakeholders in preventing and controlling mpox outbreaks, eliminating human-to-human transmission of the disease, and reducing spillover of the virus from ani...mals to humans.
Mpox is a viral illness caused by the monkeypox virus (MPXV). It can cause a painful rash, enlarged lymph nodes and fever. Most people fully recover, but some get very sick. The virus transmits from person to person through close, including sexual, contact. It also has animal reservoirs in east, central and west Africa, where spillovers from animals to humans can occasionally occur, sparking further outbreaks.
There are two different clades of the virus: clade I and clade II. Clade I outbreaks are deadlier than clade II outbreaks.
A major emergence of mpox linked to clade II began in 2017, and since 2022, has spread to all regions of the world. Between July 2022 and May 2023, the outbreak was declared a Public Health Emergency of International Concern. While that outbreak has largely subsided, cases and deaths continue to be reported today, illustrating that low-level transmission continues around the world.
Currently, there is also a major outbreak of clade I virus in the Democratic Republic of the Congo (DRC), where cases have been on the rise for decades. Since the beginning of the year, over 6500 cases and 345 deaths have been reported in the DRC. Almost half of these are among children under the age of 15 years.
The Strategic framework for enhancing prevention and control of mpox (2024–2027) provides a roadmap for health authorities, communities, and stakeholders worldwide to control mpox outbreaks in every context, advance mpox research and access to countermeasures, and to minimize zoonotic transmission.
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Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris...k factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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The United Nations Framework Convention on Climate Change (UNFCCC) established its Financial Mechanism to facilitate the provision and transfer of resources from developed to developing countries. The Global Environment Facility became the first operating entity of the Financial Mechanism after the ...Conference of the Parties (COP) to the UNFCCC, and the GEF Council agreed to a Memorandum of Understanding (MOU) in 1996. This agreement placed the GEF under the guidance of the COP, as Article 11 of the Convention states that the Financial Mechanism “shall function under the guidance of and be accountable to the Conference of the Parties, which shall decide on its policies, program priorities and eligibility criteria related to this Convention.”
The yearly COPs have provided an opportunity for Parties to update and renew their guidance to the GEF. To date, there have been 145 UNFCCC COP decisions and 526 paragraphs that offer guidance to the GEF (see Table 1). In addition, the Conferences of the Parties serving as the meeting of the Parties to the Paris Agreement (CMA) have issued 40 decisions and 115 paragraphs as guidance to the GEF (see Table 2). Key areas of Convention guidance have included: the GEF’s role as an operating entity of the Financial Mechanism, including the Paris Agreement; the GEF’s institutional and procedural reform; transparency and access to GEF funds; country engagement and empowerment; reporting on greenhouse gas (GHG) inventories; support for technology transfer; and ongoing programming in mitigation and adaptation.
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