This document presents the World Health Organization Operational framework for building climate resilient and low carbon health systems*. ***The framework's goal is to increase the climate resilience of health systems to protect and improve the health of communities in an unstable and changing clima...te, while optimizing the use of resources and implementing strategies to reduce GHG emissions. It aims to contribute to the design of transformative health systems that can provide safe and quality care in a changing climate.
Implementation of the framework's ten components would help health organizations, authorities, and programmes to be better able to anticipate, prevent, prepare for, and manage climate-related health risks and therefore decrease the burden of associated climate-sensitive health outcomes. Implementing low carbon health practices would contribute to climate change mitigation while also improving health outcomes. Achieving these aims is an important contribution to universal health coverage (UHC), global health security, and specific targets within the Sustainable Development Goals (SDGs). The document is a useful resource for decision-makers in health systems, including public health agencies, and other specialized institutions, and for decision-makers in health-determining sectors.
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There is growing understanding and high-level endorsement of the importance of strong collaborative multisectoral approaches to address a broad range of social, economic and governance issues for the prevention and control of noncommunicable disease (NCDs) and mental health conditions. In 2019, Worl...d Health Organization (WHO) Member States requested the WHO Director-General to provide an analysis across countries of successful approaches for the prevention and control of NCDs that used multisectoral action.This report describes the experiences of different countries, areas and territories in implementing multisectoral actions to tackle NCDs and is the first step to address their request for an analysis of such efforts
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Las olas de transmisión de la fiebre amarilla ocurridas en la Región de las Américas entre el 2016 y el 2018 causaron el mayor número de casos humanos y epizoóticos registrados en varios decenios. La fiebre amarilla es una enfermedad hemorrágica viral grave que representa un desafío para el p...rofesional de salud: exige el reconocimiento temprano de signos y síntomas muchas veces inespecíficos, que pueden parecerse a otros síndromes febriles agudos. La detección temprana de los casos sospechosos o confirmados, el monitoreo de los signos vitales y las medidas de soporte vital, y el tratamiento de la insuficiencia hepática aguda siguen siendo las estrategias recomendadas para el manejo de los casos. El presente informe es el resultado de las deliberaciones sobre la experiencia de expertos de la Región en cuanto al manejo clínico de pacientes con fiebre amarilla, especialmente en brotes y epidemias, mediante la contextualización de esa experiencia en el conjunto actual de la evidencia médico-científica y la consideración de las directrices técnicas ya disponibles en los países de la Región. Presenta flujogramas para la evaluación inicial del paciente con sospecha clínica de fiebre amarilla y sugiere un conjunto mínimo de pruebas de laboratorio que puede ser útil cuando hay pocos recursos; además, detalla aspectos de la organización de los sistemas de salud para enfrentar brotes y epidemias de fiebre amarilla.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) project has conducted a multi-year, multi-country study that provides stark insights on the under-reported depth of the antimicrobial resistance (AMR) crisis across Africa and lays out urgent policy recommendations to addr...ess the emergency.
MAAP reviewed 819,584 AMR records from 2016-2019, from 205 laboratories across Burkina Faso, Cameroon, Eswatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe. MAAP also reviewed data from 327 hospital and community pharmacies and 16 national-level AMC datasets.
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The Quadripartite organizations have developed the One Health Priority Research Agenda for AMR report, this is a joint initiative to assist in directing and catalysing scientific interest and financial investments for the priority research agenda across sectors for countries and funding bodies. The ...research agenda also serves as a guide to mitigate One Health AMR that will help policymakers, researchers, and a multidisciplinary scientific community work together on solutions to prevent and mitigate AMR within the One Health approach.
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This publication describes the first WHO public-benefit Target Product Profiles (TPPs) for snakebite antivenoms. It focuses on antivenoms for treatment of snakebite envenoming in sub-Saharan Africa. Four TPPs are described in the document:
Broad spectrum Pan-African polyvalent antivenoms: products ...that are intended for widespread utility throughout sub-Saharan Africa for treatment of envenoming irrespective of the species of snake causing a bite. Monovalent antivenoms for specific use cases: for products for a single species (or genus) of snake (e.g., boomslangs or carpet viper antivenoms).
Syndromic Pan-African polyvalent antivenoms for neurotoxic envenoming: products that are intended for treatment of envenoming by species whose venoms are neurotoxic. Syndromic Pan-African polyvalent antivenoms for non-neurotoxic envenoming: products for snakebite envenoming where the effects are largely haemorrhagic, necrotic or procoagulant.
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This brief considers the rationale for shielding individuals at high risk of severe disease or death from COVID-19 in low- and middleincome countries. It provides an overview of proposed approaches to shielding, discusses the categories of individuals who may be identified for shielding, and outline...s the likely difficulties of these measures and ways to mitigate them.
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Las infecciones del sitio quirúrgico (ISQ) constituyen una de las Infecciones Asociadas al Cuidado de la Salud (IACS) más frecuentes que ponen en riesgo a los pacientes llevando muchas veces al fracaso del procedimiento quirúrgico. Con una incidencia mucho mayor en países de medianos y bajos ing...resos, representa un desafío de la práctica médica cotidiana que compromete la salud y la seguridad de los pacientes. La indicación de profilaxis primaria con antibióticos en relación a los procedimientos invasivos, tiene como objetivo disminuir la incidencia de infecciones con la consecuente disminución de la morbimortalidad debiendo utilizarse únicamente en aquellos procedimientos en los que hay evidencia de efectividad. Cabe destacar que la indicación inadecuada, tiene potenciales efectos adversos tales como infecciones por Clostridium difficile, emergencia de resistencia
bacteriana, reacciones adversas a drogas e incremento de los costos en salud.
La profilaxis antibiótica como complemento de una buena técnica quirúrgica, es una medida costo efectiva de prevención de las ISQ representando alrededor del 30% de la indicación de antibióticos entre los pacientes hospitalizados. Dado que en algunos estudios el uso inapropiado de antibióticos se ve reflejado en el 40 al
80% de las indicaciones médicas, desde la Comisión de Infecciones Asociadas al Cuidado de la Salud y Seguridad del Paciente de SADI hemos realizado una actualización de la evidencia disponible. Este documento es una acción complementaria al consenso “Prevención de Infección del Sitio Quirúrgico” realizado entre SADI y el Instituto Nacional de Epidemiología “J. Jara” durante el Congreso de SADI 2015.
La posibilidad de contar con una guía actualizada de profilaxis quirúrgica adaptada a nuestro medio, constituye una herramienta de uso cotidiano por parte de los profesionales del equipo quirúrgico que permite la optimización de la utilización de fármacos restringiendo así la emergencia y diseminación de la resistencia bacteriana. Sin duda esperamos que pueda ser de utilidad para el equipo de salud.
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Following the publication of Guidelines on certification of elimination of human onchocerciasis in 2001 by the World Health Organization (WHO), these are the first evidence-based guidelines developed by NTD Department according to the international standards. They provide a set of recommendations th...at would guide national programme managers in collaboration with their respective oversight committees on when to stop mass drug administration (MDA) and conduct post-treatment surveillance (PTS) activities for a minimum period of 3 to 5 year before confirming the interruption of transmission of Onchocerca volvulus parasite and hence its elimination. They also include steps to undertake for verification of elimination of transmission of the parasite in the whole endemic country by the International Verification Team (IVT) prior to the official acknowledgement by WHO Director General.
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Este manual se ha elaborado en el marco de la Iniciativa Global de la Organización Mundial de la Salud (OMS) para el Cáncer Infantil, CureAll Americas, con el propósito de mejorar la situación de los niños, niñas y adolescentes con cáncer en todo el mundo, para que puedan tener las mejores po...sibilidades de sobrevida, disfrutar de una vida plena y, sobre todo, alcanzar la mejor calidad de vida posible y morir sin sufrimiento. Está dirigido a los profesionales de la salud que se dedican al tratamiento de pacientes oncológicos pediátricos y que, directa o indirectamente, deben enfrentarse con las complicaciones que pueda causar el tratamiento a todos los niveles. Su contenido puede contribuir a la realización de un diagnóstico más certero de las alteraciones de la cavidad oral, así como al desarrollo de estrategias para la prevención y el tratamiento de estas manifestaciones. No se establecen orientaciones directas para responsables parentales ni cuidadores, pero sí se presenta información que sirve como guía para el cuidado bucal, de acuerdo con la estructura y la composición de los equipos de los distintos centros de tratamiento contra el cáncer.
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Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis is a life-threatening disease and recognized as an important cause of pulmonary haemorrhage syndrom...e, the lack of global estimates for morbidity and mortality has contributed to its neglected disease status
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Mycetoma is a chronic infectious disease of the subcutaneous tissue with a high morbidity. This disease has been reported from countries between 30°N and 15°S since 1840 but the exact burden of disease is not known. It is currently unknown what the incidence, prevalence and the number of reported ...cases per year per country is. In order to estimate what the global burden of mycetoma is, a meta-analysis was performed. In total 50 studies were included, which resulted in a total of 8763 mycetoma cases. Most cases were found in men between 11 and 40 years of age. The foot was most commonly affected.
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The major neglected tropical diseases, Taenia solium taeniosis/cysticercosis and schistosomiasis caused by Schistosoma mansoni or S. haematobium are presumed to be widely distributed in Africa. Taenia solium taeniosis/ cysticercosis has been reported as an emerging disease in different regions of Af...rica [1, 2], but currently the exact distribution remains unclear. Reported prevalences of T. solium taeniosis and cysticercosis in African countries are not extensive and are further complicated by the lack of ‘gold standard’ tests for diagnosis.
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This report provides an overview of the main findings of the 2019–2020 harmonised AMR monitoring in the main food-producing animal populations monitored, in carcase/meat samples and in humans. Where available, monitoring data obtained from pigs, calves, broilers, laying hens and turkeys, as well a...s from carcase/meat samples and humans were combined and compared at the EU level, with particular emphasis on multidrug resistance, complete susceptibility and combined resistance patterns to critically important antimicrobials, as well as Salmonella and E. coli isolates possessing ESBL-/AmpC-/carbapenemase phenotypes.
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The publication of the of the Antimicrobial Treatment Guidelines represents the
culmination of the efforts of the Antimicrobial Stewardship Program of ICMR to publish treatment guidelines for common syndromes in India. These guidelines are targeted for the health care settings. It aims to rationali...ze the usage of antibiotics on our Essential Medicines Formulary (EMF) and to establish consistency in the treatment of various infectious conditions.
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The European Union Agency for Fundamental Rights (FRA) collected evidence through field missions and from other sources reporting on the situation in March, May and October 2022.
In parallel, it launched a large-scale online survey of those fleeing Ukraine. This aimed to gather personal experiences... of their journey to, arrival in and settling in the EU. The survey covered displaced people, including many children, in the 10 EU Member States hosting large numbers of people registered for temporary protection.
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En este folleto se resume la situación de los sistemas y servicios de salud en la Región de las Américas en su progreso hacia el acceso universal a la salud y la cobertura universal de salud (la “salud universal”). Se presenta la situación previa a la pandemia de COVID-19, el efecto que ha t...enido en los sistemas de salud y las recomendaciones para encarar los retos actuales y futuros en la construcción de sistemas de salud resilientes que permitan seguir avanzando hacia la salud universal en la Región.
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In May the Sixty-sixth World Health Assembly adopted resolution WHA66.12 (1) on 17 neglected tropical diseases (NTDs). Among other measures, the resolution urges Member States to:
• ensure country ownership of prevention, control, elimination and eradication programmes;
• expand and implemen...t interventions and advocate for predictable, long-term international financing for activities related to control and capacity strengthening;
• integrate control programmes into primary health-care services and existing programmes;
• ensure optimal programme management and implementation;
• achieve and maintain universal access to interventions and reach the targets of the roadmap.
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A wide spectrum of disease severity has been described for Human African Trypanosomiasis (HAT) due to
Trypanosoma brucei rhodesiense (T.b. rhodesiense), ranging from chronic disease patterns in southern countries of East Africa to an increase in virulence towards the north. However, only limited d...ata on the clinical presentation of T.b. rhodesiense HAT is available. From 2006-2009 we conducted the first clinical trial program (I MPAMEL III) in T.b. rhodesiense endemic areas of
Tanzania and Uganda in accordance with international standards (ICH-GCP). The primary and secondary outcome measures were safety and efficacy of an abridged melarsoprol schedule for treatment of second stage disease. Based on diagnostic findings and clinical examinations at baseline we describe the clinical presentation of T.b. rhodesiense HAT in second stage patients from two distinct geographical settings in East Africa.
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