22nd edition
The purpose of the SAHR has always been to analyse and assess progress and challenges in key areas of the health system, and to propose recommendations for improvement. We are pleased to continue this tradition in the 2019 edition, which presents a unique collection of perspectives on ...the key challenges in implementing universal health coverage (UHC) in South Africa, as analysed by experts in various fields.
Each of the 20 chapters deals with aspects of the UHC journey, dedicated towards an equitable and inclusive national health system that leaves no-one behind. While some authors describe the fundamental changes and practical considerations required to reconfigure the country's health system, others have reflected on specific programmatic areas and have made recommendations from a National Health Insurance (NHI)/UHC lens.
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PEPFAR Malawi’s Country Operational Plan 2022 (COP22) embodies joint priorities from national and subnational dialogues building on the 2020-2025 National Strategic Plan for HIV/AIDS. The interagency team has developed a person-centered, district-tailored and Malawi Population-Based HIV Impact Ass...essment (MPHIA)-informed strategy through extensive engagement with Government of Malawi (GoM) and Civil Society Organizations (CSOs) to sustain HIV epidemic control. At the end of COP21, PEPFAR Malawi was commended for contributing to reaching epidemic control in strong collaboration with GoM and stakeholders including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). This includes enrollment of 88% of recipients of care on three or more months of antiretroviral treatment (ART), better outcomes for Malawian children through remarkable efforts in Orphans and Vulnerable Children (OVC) programming and progress made towards reaching men with more intentional and focused programming.
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This Guideline, the first for the country, draws from national health sector reforms and integration agenda as outlined in the key national strategic documents. The Guide applies lessons learnt from the SRH/HIV Linkages project and its scale-up; other national experiences and from regional and globa...l evidence and guidance on high-impact interventions that promote sustainable, equitable and effective delivery of health services to achieve Universal Health coverage.
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As part of the UN’s data strategy—which seeks to nurture data as a strategic asset for insight, impact and integrity—UNAIDS plays an indispensable role in generating data for effective action against the AIDS pandemic. It leads the
world’s most extensive data collection on HIV epidemiology,... programme coverage, policy and finance, and it publishes the most authoritative and up-to-date information on the HIV pandemic and response. The UNAIDS database of countryreported data is a foundational pillar for global and regional AIDS programmes, research, advocacy and resource mobilization
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In 2007, WHO warned that infectious diseases are emerging and re-emerging at a rate that has not been seen before. The potential for infectious diseases to spread rapidly results in high morbidity and mortality, causing a potential global public health treat of major concern.
Several factors are ...contributing to the (re)emergence of infectious diseases such as population growth, living in close contact with animals, frequent travelling, poverty, destructive ecological changes due to economic development and land use and climate change result in global warming.
Especially Africa is at a threat for (re)emerging infectious diseases due to the huge population growth (expected to reach 2.5 billion by 2050) with rapid urbanisation. Additionally, people across and beyond the continent are excessively mobile which is combined with a weak health system. Moreover, the risk of (re)emerging infectious disease is further heightened by three newly adopted continental initiatives: African Continental Free Trade Area, Free Movement of Persons and African Passport and Single African Air Transport Market.
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UNAIDS report on the global AIDS epidemic shows that 2020 targets will not be met because of deeply unequal success; COVID-19 risks blowing HIV progress way off course. Missed targets have resulted in 3.5 million more HIV infections and 820 000 more AIDS-related deaths since 2015 than if the world w...as on track to meet the 2020 targets. In addition, the response could be set back further, by 10 years or more, if the COVID-19 pandemic results in severe disruptions to HIV services.
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Antimicrobial resistance (AMR) has emerged as a leading cause of death in the African region, surpassing fatalities from malaria, HIV, and TB. In response to this critical threat, the region has adopted the AMR Global Action Plan and the African Union Framework for Antimicrobial Resistance Control 2...020 – 2025, which is tailored to meet the specific needs of African nations through a coordinated approach. While most countries in the region have developed and prioritized National Action Plans (NAPs) to tackle AMR, the overall response remains inadequate given the magnitude of the threat, which endangers human, animal, environmental, aquatic, and plant health.
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This publication seeks to describe the best treatments and practices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws o...f their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all the unwanted effects of medications are mentioned.
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22nd edition
Each of the 20 chapters deals with aspects of the UHC journey, dedicated towards an equitable and inclusive national health system that leaves no-one behind. While some authors describe the fundamental changes and practical considerations required to reconfigure the country's health sy...stem, others have reflected on specific programmatic areas and have made recommendations from a National Health Insurance (NHI)/UHC lens.
In addition, we are pleased to announce that this year's edition includes two innovations. First is the provision of concise summaries of the chapters in the form of 'chapters at a glance'. These are positioned together at the start of the publication for ease of reference and to give a quick overview. The second innovation is the introduction of our Healthcare Workers' Writing Programme (HCWWP), which provides support to first-time authors wanting to publish in the Review.
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Reports of antimicrobial-resistant (AMR) microorganisms are increasing globally, threatening to render existing treatments ineffective against many infectious diseases. In Africa, AMR has already been documented to be a problem for human immunodeficiency virus (HIV) and the pathogens that cause mala...ria, tuberculosis (TB), typhoid, cholera, meningitis, gonorrhoea and dysentery. Recognizing the urgent need for action, the 2016 United Nations (UN) General Assembly approved a resolution to ensure sustained and effective global action to address AMR.
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This guide provides an overview of the major elements that must be considered before, during and after the implementation of antigen-detecting rapid diagnostic tests (Ag-RDTs) for SARS-CoV-2. This guide is complementary to policy guidance issued by the World Health Organization (WHO). The guide may ...appeal to a range of audiences including Ministries of Health, donors, public and private organizations/agencies acting as implementing partners and community based and civil society organizations with experience working on health, especially organizations familiar with similar testing campaigns for other disease programmes like HIV and malaria
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A lack of knowledge about the threat of vaccine-preventable diseases, risks and benefits of vaccines, mistrust of government and health workers, poor service delivery and alternative health or religious beliefs play a role in lower uptake of some vaccines. These challenges underscore the importance ...of early integration and investment in a thoughtful communication plan for immunization programmes. This World Health Organization (WHO) report presents communication guidance and specific considerations for countries that plan to introduce human papillomavirus (HPV) vaccine into their national immunisation programme as part of an effort to prevent cervical cancer.
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The world is not on track to end the AIDS pandemic. New infections are rising and AIDS deaths are continuing in too many communities. This report reveals why: inequalities are holding us back. In frank terms, the report calls the world’s attention to the painful reality that dangerous inequalities... are undermining the AIDS response and jeopardising the health security of everyone. The report highlights three specific areas of inequality for which concrete action is immediately possible—gender
inequalities and harmful masculinities driving HIV; marginalisation and criminalisation of key populations, which our data show is resulting in starkly little progress for those populations and undermining the overall response; and
inequalities for children whose lives must matter more than their market share. But this is not a counsel of despair, it is a call to action. Through bold action to confront these inequalities, we can end AIDS.
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A historic funding crisis is threatening to unravel decades of progress unless countries can make radical shifts to HIV programming and funding. The report highlights the impact that the sudden, large-scale funding cuts from international donors are having on countries most affected by HIV. Yet it a...lso showcases some inspiring examples of resilience, with countries and communities stepping up in the face of adversity to protect the gains made and drive the HIV response forward.
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A historic funding crisis is threatening to unravel decades of progress unless countries can make radical shifts to HIV programming and funding. The report highlights the impact that the sudden, large-scale funding cuts from international donors are having on countries most affected by HIV. Yet it a...lso showcases some inspiring examples of resilience, with countries and communities stepping up in the face of adversity to protect the gains made and drive the HIV response forward.
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Five years after a global commitment to Fast-Track the HIV response and end AIDS by 2030, the world is off track. A promise to build on the momentum created in the first decade of the twenty-first century by front-loading investment and accelerating HIV service provision has been fulfilled by too fe...w countries
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This document lays out economic arguments for investing in the Access to COVID-19 Tools Accelerator (ACT-Accelerator). Framed within an overall context that recognizes the broader human health and societal impacts of the COVID-19 crisis, ACT-Accelerator's Economic Investment Case argues that investm...ent in ACT-Accelerator is the world’s best bet and most viable solution for restarting the global economy. It is intended for governments, multilaterals, civil society, businesses and foundations and all those interested in the work required to change the course of the pandemic. The global deployment of ACT-Accelerator’s comprehensive package of tools will reduce the severity of COVID-19 disease, enabling countries to transition out of the crisis thereby restarting domestic and international economic engines driving our global economy.
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PEPFAR Malawi’s Country Operational Plan (COP) 2021 reflects a culmination of strong interagency collaboration between the PEPFAR Malawi team, Government of Malawi (GoM), and civil society organizations (CSOs) to mitigate the devastating impacts of COVID-19 and sustain progress achieved over the l...ast two decades towards HIV epidemic control.
At the conclusion of the March 2020 Johannesburg Regional Planning Meeting, the PEPFAR Malawi team presented a COP20 surge strategy to improve client-centered care, mitigate treatment disruption, scale prevention programs to key and vulnerable populations, and strengthen national health systems.
Following this meeting, the first three COVID-19 cases were reported in Malawi and immediately thereafter, adaptations to the COP20 strategy became imperative to deliver safe, client-centered care.
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