The greatest risk to persons engaging in international medical emergency response is poor preparation.
The In Control handbook hopes to provide a remedy.
At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health emergency that disregards physical borders, brin...gs into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated.
Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all.
The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world.
The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards.
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The National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), 2020-2025, presents
coordinated, strategic actions that the United States Government will take in the next five years to improve the health and wellbeing of all Americans by changing the course of antibiotic resistance.
T...his Plan is based on the U.S. Government’s 2014 National Strategy for CARB, and builds on the first National Action Plan released in 2015 by expanding evidence-based activities that have already been shown to reduce antibiotic resistance, such as optimizing the use of antibiotics in human and animal health settings.
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Antimicrobial agents play an indispensable role in animal health and welfare management. At the same time, the need for prudent use is obvious to ensure good food safety outcomes and to manage the potential risk of antimicrobial resistance. The emergence of multi-resistant bacteria is posing challen...ges to health professionals and communities around the world for both human and animal health. These bacteria are not destroyed by the common antimicrobial agents and so pose a risk to people, particularly children, the elderly and those with poorly functioning immune systems, as well as to animals.
Throughout the years, the dairy sector has been very much aware of the need for responsible use and has, in many countries, implemented adequate measures throughout the dairy supply chain.
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The introduction of vaccines for coronavirus disease 2019 (COVID-19) added another measure to the existing set of
recommended preventive measures (wearing a mask in public, keeping a distance from other people and regular handwashing). The roll-out of the vaccines, however, raised concerns that vac...cination may lead to lower adherence to the existing
preventive measures. The advice from the World Health Organization (WHO) was to continue these public health and
social measures after being vaccinated.1 However, evidence from other epidemics suggests that there is lower adherence to
preventive measures when some level of protection exists (for example, individuals who use human immunodeficiency virus
pre-exposure prophylaxis
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This module is part of the WHO series The Immunological Basis for Immunization, which was initially developed in 1993 as a set of eight modules, comprising one module on general immunology and seven modules each devoted to one of the vaccines recommended for the Expanded Programme on Immunization, i....e. vaccines against diphtheria, measles, pertussis, polio, tetanus, tuberculosis and yellow fever. Since then, this series has been updated and extended to include other vaccines of international importance. The main purpose of the modules is to provide national immunization managers and vaccination professionals with an overview of the scientific basis of vaccination against a range of important infectious diseases. The modules developed since 1993 continue to be vaccine-specific, reflecting the biological differences in immune responses to the individual pathogens and the differing strategies employed to create the best possible level of protection that can be provided by vaccination. The modules also serve as a record of the immunological basis for the WHO recommendations on vaccine use, published in the WHO vaccine position papers.*
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Nature, biodiversity and health: an overview of interconnections
Urbanization, land use, global trade and industrialization have led to profound and negative impacts on nature, biodiversity and ecosystems across the world. The ongoing depletion of natural resources not only affects environmental c...onditions but also has an enormous impact on the well-being and security of societies.
This report provides an overview of the impacts of the natural environment on human health. It presents the ways nature and ecosystems can support and protect health and well-being, and describes how nature degradation and loss of biodiversity can threaten human health. It is targeted at readers who do not have extensive experience with the links between nature and health.
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Interim guidance 2 February 2021 . Available in Arabic, Chinese, English, French, Ukranian, Russian
Health workers are at the front line of the COVID-19 outbreak response and as such are exposed to different hazards that put them at risk. Occupational hazards include exposure to SARS-CoV-2 and othe...r pathogens, violence, harassment, stigma, discrimination, heavy workload and prolonged use of personal protective equipment (PPE). This document provides specific measures to protect occupational health and safety of health workers and highlights the duties, rights and responsibilities for health and safety at work in the context of COVID-19.
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13 May 2021
To avoid a reversal of progress from the adverse impacts of the COVID-19 pandemic, new knowledge and lessons from successful programmatic innovations are urgently needed to improve TB prevention and care. Experience can provide evidence for innovative approaches and strategies to mainta...in and scale up high-quality TB services. WHO therefore called for case studies on programmatic innovations that address emerging challenges in TB prevention and care during the pandemic in order to collect and disseminate the findings to the TB community. Between November 2020 and February 2021, a total of 23 case studies relevant to the call were accepted from 19 countries in the six regions of WHO. The lessons learnt from these country activities to ensure the continuity of essential services like TB care in the face of the crippling crisis may also inform strategies for minimizing the impact of future emerging pathogens on health services.
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Interim guidance 2 February 2021 . Available in Arabic, Chinese, English, French, Ukranian, Russian
Health workers are at the front line of the COVID-19 outbreak response and as such are exposed to different hazards that put them at risk. Occupational hazards include exposure to SARS-CoV-2 and othe...r pathogens, violence, harassment, stigma, discrimination, heavy workload and prolonged use of personal protective equipment (PPE). This document provides specific measures to protect occupational health and safety of health workers and highlights the duties, rights and responsibilities for health and safety at work in the context of COVID-19.
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Left unabated, climate change will have catastrophic effects on the health of present and future generations. Such effects are already seen in Europe, through more frequent and severe extreme weather events, alterations to water and food systems, and changes in the environmental suitability for infe...ctious diseases. As one of the largest current and historical contributors to greenhouse gases and the largest provider of financing for climate change mitigation and adaptation, Europe’s response is crucial, for both human health and the planet. To ensure that health and
wellbeing are protected in this response it is essential to build the capacity to understand, monitor, and quantify health impacts of climate change and the health co-benefits of accelerated action.
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Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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This guidance note is for UNICEF Regional and Country Office WASH staff to help them in their preparedness and response to the current COVID-19 global pandemic. It provides an overview of Infection Prevention and Control (IPC) and its intersection with water, sanitation and hygiene (WASH) and how UN...ICEF staff can help prevent infection and its spread in schools, through human to human and by touching surfaces contaminated with the virus. WASH services including waste management and environmental cleaning are all important for IPCs.
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This guidance note developed by UNICEF is intended to help WASH staff in their preparedness and response to the current COVID-19 pandemic. It provides an overview of Infection Prevention and Control (IPC) and its intersection with water, sanitation and hygiene (WASH), and how staff can help prevent ...infection and its spread in schools, whether through human-to-human or by touching surfaces contaminated with the virus. WASH services, including waste management and environmental cleaning, are all important for IPC. This brief is available in English, Spanish, and French here.
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The following protocol has been designed to investigate the First Few X cases (FFX) and their close contacts. It is envisioned that the FFX 2019-nCoV investigation will be conducted across several countries or sites with geographical and demographical diversity. Using a standardized protocol such a...s the protocol provided here, epidemiological exposure data and biological samples can be systematically collected and shared rapidly in a format that can be easily aggregated, tabulated and analyzed across many different settings globally for timely estimates of 2019-nCoV infection severity and transmissibility, as well as to inform public health responses and policy decisions. This is particularly important in the context of a novel respiratory pathogen, such as 2019-nCoV
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Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as viral hepatitis, in particular chronic infection, is a silent and neglected cause of morbidity and mortality. However, the burden of disease i...s likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
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The GHS Index is intended to be a key resource in the face of increasing risks of high-consequence and globally catastrophic biological events and in light of major gaps in international financing for preparedness. These risks are magnified by a rapidly changing and interconnected world; increasing ...political instability; urbanization; climate change; and rapid technology advances that make it easier, cheaper, and faster to create and engineer pathogens.
Key findings from the study of 195 countries:
• Out of a possible 100 points, the average GHS Index score across 195 countries was 40.2.
• The majority of high- and middle-income countries do not score above 50.
• Action is urgently needed to improve countries’ readiness for high-consequence infectious disease outbreaks.
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Antimicrobial resistance (AMR) is a multifaceted, international public health problem, which poses a direct threat to the safety of the population of South Africa. A national response is required to complement the development of a global plan, as articulated in the WHO’s draft resolution EB134/37 ...“Combating antimicrobial resistance including antibiotic resistance”, adopted by theWorld Health Assembly in May 2014. The overuse of antimicrobials is driving resistance. A return to appropriate, targeted antimicrobial use in humans, animals and the environment is critical if we are to conserve the antimicrobial armamentarium. Various interventions have been put in place to address antimicrobial resistance in South Africa. However, these are insufficient to effectively tackle the threat faced by the country. The strengths of the current system are outweighed by its weaknesses.
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This curricula guide builds on several existing products of WHO and partners, aimed at supporting countries in their effort to address the first objective of the GAP-AMR (to improve awareness and understanding of AMR). It is targeted specifically at health educators and policy planners, and applies ...a systematic modular and submodular collection of learning objectives and outcomes that are organized according to the key occupational groups involved in the use of antimicrobials in human health. It is hoped that educators, faculties of heath personnel training institutions, health regulatory institutions and other users will find it a useful resource in meeting their respective needs for strengthening health workers’ contributions to containing AMR.
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The global tripartite self-assessment survey of country progress in addressing antimicrobial resistance (AMR) is a component of a broader approach for monitoring and evaluation of the global action plan on AMR. This report analyses the results of the second tripartite self-assessment survey. It has ...been developed and run by the three Tripartite organizations (Food and Agriculture Organization of the United Nations (FAO), World Organisation for Animal Health (OIE) and World Health Organization (WHO)) and reflects progress in the human, animal (terrestrial and aquatic), plant, food safety and environmental sectors. 154 countries out of 194 WHO Member States responded to this round of the self-assessment survey – a response rate of 79.4%.
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Scientists have known for more than half a century that patients could develop resistance to the drugs used to treat them. Alexander Fleming, who is credited with creating the first antibiotic, penicillin, in 1928, cautioned of the impending crisis while accepting his Nobel prize in 1945: “There ...is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.” Since then antibiotics have proved one of the most effective interventions in human medicine. Sadly, the overuse and misuse of this precious resource have brought us to a global crisis of antimicrobial resistance (AMR). To address this crisis nearly seven decades after Fleming’s lecture the first UN general assembly meeting on drug resistance bacteria was convened in September 2017.
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