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A new formulation of a drug to prevent excessive bleeding following childbirth could save thousands of women’s lives in low- and lower-middle-
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income countries, according to a study led by the World Health Organization (WHO) in collaboration with MSD for Mothers and Ferring Pharmaceuticals.
Currently WHO recommends oxytocin as the first-choice drug for preventing excessive bleeding after childbirth. Oxytocin, however, must be stored and transported at 2–8 degrees Celsius, which is hard to do, in many countries, depriving many women of access to this lifesaving drug. When they can obtain it, the drug may be less effective because of heat exposure.
more
The global burden of disease due to mental disorders continues to rise, especially in low- and middle-i
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ncome countries (LMIC). In addition to causing a large proportion of morbidity, mental disorders – especially severe mental disorders (SMD) – are linked with poorer health outcomes and increased mortality. SMD are defined as a group of conditions that include moderate to severe depression, bipolar disorder, and schizophrenia and other psychotic disorders. People with SMD have a two to three times higher average mortality compared to the general population, which translates to a 10-20 year reduction in life expectancy. While people with SMD do have higher rates of death due to unnatural causes (accidents, homicide, or suicide) than the general population, the
majority of deaths amongst people with SMD are attributable to physical health conditions, both
non-communicable and communicable.
more
Q5: What is the added advantage of doing an electroencephalography (EEG) in people with convulsive epilepsy in non- specialist settings in low and middle
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income countries?
more
Soapbox Collaborative has launched a new training package called TEACH CLEAN, which is a package for those that clean health care facilities in low- and m
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iddle-income countries. The TEACH CLEAN package presents information and materials required to deliver comprehensive, participatory training on safe environmental cleaning, applying aspects of essential IPC for these tasks. The package is tailored towards use with low-literate cleaning staff but can be applied to wider facility staff.
To request a copy of the TEACH CLEAN Package, or supporting materials, please complete the online form.
more
Regional implementation framework for elimination of cervical cancer as a public health problem: 2021–2030
recommended
Cervical cancer continues to be a significant public health problem and a major cause of premature mortality among women, disproportionately affecting the socioeconomically disadvantaged population in low
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- and middle-income countries (LMICs). In the absence of implementing the known evidence-based, cost-effective interventions, the number of deaths per year is projected to reach approximately 416 000 globally in 2035. It was estimated in 2020 that 32% of incident cervical cancer cases and 34% of cervical cancer deaths in the world occurred in the 11 Member States of the WHO South-East Asia (SEA) Region. In 2020, 190 874 new cases and 116 015 deaths were estimated due to cervical cancer, which is the third commonest cancer in the Region
more
Access to safe blood and blood products is recognized as one of the key requirements for delivery of modern health care in the journey towards health for all. The foundation of safe and sustainable
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blood supplies depends on the collection of blood from voluntary non-remunerated and low-risk donors. Data from the WHO Global Database for Blood Safety (GDBS) brings out several inadequacies related to the supply and safety of blood and blood products. These inadequacies include a number of variations in safe blood practices across the world, including the quantity of blood donated (voluntary and replacement types), quality and adequate testing of the donated blood (immunohaematology [IH] and transfusion-transmitted infections [TTIs]), rational use of blood and blood components such as appropriate patient blood management protocols. These variations are very high in countries of the South-East Asian Region and most of them are either low- or middle-income countries (LMICs).
more
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
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Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental factors (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.
more
The Movement for Global Mental Health (MGMH) is a virtual network of individuals and organisations that aim to improve services for people living with mental health problems and psychosocial disabil
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ities worldwide, especially in low- and middle-income countries (LMIC) where effective services are often scarce.
Two principles are fundamental to the Movement: scientific evidence and human rights.
more
No one should be harmed in healthcare. And yet, at least five people die every minute of patient safety failures in low and
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middle income countries alone. We can all do something to save these lives. Join us, commit to Patient Safety. Speak up for Patient Safety
more
Chronic Obstructive Pulmonary Disease (COPD) is now one of the top three causes of death worldwide and 90% of these deaths occur in low- and
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middle-income countries (LMICs).
More than 3 million people died of COPD in 2012 accounting for 6% of all deaths globally. COPD represents an important public health challenge that is both preventable and treatable. COPD is a major cause of chronic morbidity and mortality throughout the world; many people suffer from this disease for years and die prematurely from it or its complications. Globally, the COPD burden is projected to increase incoming decades because of continued exposure to COPD risk factors and aging of thepopulation.
more
Over the past decade, countries in the African region experienced slow progress in mobilizing resources for health while facing continued challenges. In their revised estimates published in 2017, Stenberg et al., developed two costs scenarios, terme
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d progress and ambitious, aimed at strengthening comprehensive health service delivery to achieve SDG 3 and universal health coverage in low-income and middle-income countries (Stenberg et al., 2017). Out of the 47 countries in the WHO African region only eight, on average, met the recommended threshold of spending a minimum of US$ 249 per capita on health during the period from 2012 to 2020. In 2020, this achievement was observed in only five countries while the remaining countries spent less than US$ 249 per capita, with health expenditures ranging from US$ 16.4 to US$ 236.6, highlighting significant disparities across the region.
more
The uneven distribution of HIV risks and burdens across populations is a well-substantiated fact, though seldom publicly acknowledged. Gay men and other men who have sex with men, people who inject
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drugs, sex workers, and transgender women are 24, 24, 13.5, and 49 times more likely to acquire HIV, respectively, than other reproductive aged adults (15 years old and older). Globally, new infections among these key populations account for 45% of all new HIV infections. This figure is likely to be an underestimate, given the intense stigma associated with disclosing and reporting acquisition risks for HIV among gay men, people who use drugs, sex workers, and transgender people. In addition, HIV epidemics in the majority of low- and middle-income countries (90 of 120) have concentrated epidemics among key populations. In countries with more broadly generalized epidemics, risks are still not evenly distributed and key populations still shoulder disease burden that is markedly disproportionate.
more
Globally each year, millions of people suffer illness or lose their lives because the vaccines, medicines and diagnostic tests that they need are either unavailable or unaffordable – and this lack
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of access to medicine is acute in low- and middle-in-
come countries (LMICs). While the COVID-19 pandemic laid this inequity bare, it also saw the pharmaceutical industry develop and bring new vaccines and treat- ments to market at unprecedented speed. As the world emerges from the worst
of this crisis, pharmaceutical companies are now at an important juncture, where lessons learned from the pandemic can prove pivotal in finding solutions to bridge long-standing gaps in access to medicine in LMICs.
more
Suicides take a high toll. Over 800 000 people die by suicide every year and it is the second leading cause of
death in 15-29-year-olds. Most suicides occur in low-
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and middle-income countries where resources
and services, if they do exist, are often scarce and limited for early identification, treatment and support of
people in need. These striking facts and the lack of implemented timely interventions make suicide a serious
global public health problem that needs to be tackled urgently.
more
These organisations have joined forces to accelerate access to COVID-19 vaccines, therapeutics and diagnostics by leveraging multilateral finance and trade solutions, particularly for
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low- and middle-income countries.
The aim is to vaccinate at least 40 percent of people in every country by the end of 2021, and at least 60 percent by mid-2022. The effort will track, coordinate, and advance delivery of COVID-19 vaccines, therapeutics and diagnostics, working with governments and partners at the global and local levels to address finance and trade barriers to ensure that vulnerable populations have access to these life-saving tools. It supports the goals of the ACT-Accelerator and complementary initiatives.
more
International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines
recommended
ecancer has just published a comprehensive set of guidelines for paediatric cancer surgery, applicable to low and high resource settings across the world. You can read the guidelines online
The g
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uidelines have been developed by the International Society of Paediatric Surgical Oncology (IPSO) with authors from both High Income Countries and Lower and Middle Income Countries, and have been further validated by experts in the respective fields with the aim of providing evidence-based information for surgeons who care for children with cancer.
These guidelines include information on the care and treatment of children with malignancies, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumours (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life.
more
Childhood cancer is curable for the vast majority of children when essential diagnostic, therapeutic and supportive care services are accessible. However, profound inequalities in outcomes exist within and
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between countries with as few as 20% or 30% of children living in low- and middle-income countries surviving.
The Global Initiative for Childhood Cancer Overview document presents the CureAll approach to support governments, partners and communities achieve the best possible cancer care for all children. This approach, summarized as four pillars of action supported by three enablers, will improve the care for children with cancer around the world.
more
This technical report summarizes the discussions on the status of programmatic transition to tenofovir, lamivudine and dolutegravir (TLD) in low– and
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middle- income countries, addressing the best practices and major challenges faced by HIV programmes.
The latest data on safety and efficacy of dolutegravir (DTG) containing regimens were also reviewed. The document identified the remaining gaps in knowledge, research, monitoring, and surveillance on DTG and TLD transition and listed the future priorities.
more
As climate change increasingly contributes to migration and displacement in many parts of the world, there is a pressing need for measures that build resilience and prevent displacement as well as t
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hose that help climate-affected people move to safety and support receiving communities. Multilateral development banks (MDBs) are critical, if sometimes overlooked, players because of their ability to invest in large-scale projects that contribute to sustainable development, primarily in low- and middle-income countries.
This report explores the unique role of MDBs in the climate finance landscape and highlights opportunities for migration, humanitarian, and other key actors to partner with them on projects that effectively target climate-related migration and displacement. After reviewing the evidence on the complex linkages between climate and mobility, the report examines MDBs’ climate-related work to date, challenges they face to scaling up these efforts, and strategies to begin to address hurdles. These recommendations include learning from past MDB investments that have touched on climate migration, funding data collection or sharing to strengthen understanding of climate migration trends, and developing partnerships to support policy and project development, financing, and implementation.
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BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in
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low- and middle-income countries and remains under-recognised and poorly managed.
OBJECTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
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