MEDBOX Issue Brief no.18.
The MEDBOX team has compiled a new issue brief on the impact of COVID-19 on PLHIV HIV prevention programmes and treatment for this year's World AIDS Day on 1 December 2021.
This report investigates the impact of potential misclassification of samples on HIV prevalence estimates for 23 surveys conducted from 2010-2014. In addition to visual inspection of laboratory results, we examined how accounting for potential misclassification of HIV status through Bayesian latent ...class models affected the prevalence estimates. Two types of Bayesian models were specified: a model that only uses the individual dichotomous test results and a continuous model that uses the quantitative information of the EIA (i.e., the signal-to-cutoff values). Overall, we found that adjusted prevalence estimates matched the surveys’ original results, with overlapping uncertainty intervals. This suggested that misclassification of HIV status should not affect the prevalence estimates in most surveys. However, our analyses suggested that two surveys may be problematic. The prevalence could have been overestimated in the Uganda AIDS Indicator Survey 2011 and the Zambia Demographic and Health Survey 2013-14, although the magnitude of overestimation remains difficult to ascertain. Interpreting results from the Uganda survey is difficult because of the lack of internal quality control and potential violation of the multivariate normality assumption of the continuous Bayesian latent class model. In conclusion, despite the limitations of our latent class models, our analyses suggest that prevalence estimates from most of the surveys reviewed are not affected by sample misclassification.
more
This strategy defines the World Health Organization (WHO) vision and framework for supporting Member States to accelerate the development, implementation and monitoring of their National Action Plan for Health Security (NAPHS) from 2022 to 2026. The National Action Plan for Health Security (NAPHS) ...are critical to ensure national capacities in health emergency prevention, preparedness, response and recovery are planned, built, strengthened and sustained in order to achieve national, regional and global health security and therefore keep the world safe, serve the vulnerable and promote health.
The strategy promotes, where existing, the use of existing national action plans for health security and not necessary the creation of an additional unique plan. This will avoid duplication and ensure maximum efficiency in domestic resourcing and operationalization efficiency while harnessing external buy-in to support national health priorities.
more
This Framework offers a coherent approach for eliminating tuberculosis (TB) in low-incidence countries. It is designed to guide national policy-makers and those responsible for technical aspects of the national TB response in accelerating efforts towards elimination. The document will also be inform...ative for public health surveillance officers, practitioners and nongovernmental and civil society partners working on natioal TB care and prevention and serving the populations most vulnerable to TB.
more
The World Health Organization (WHO) launched the SAFER initiative in 2018 to address the global health and societal challenges posed by alcohol-related harm. The initiative outlines five key strategies aimed at reducing alcohol consumption and its associated consequences. These include strengthening... restrictions on alcohol availability by implementing and enforcing policies to limit its accessibility and advancing drink-driving countermeasures, such as low blood alcohol concentration limits and random breath testing, to reduce alcohol-impaired driving incidents.
Additionally, SAFER emphasizes facilitating access to screening, brief interventions, and treatment for individuals with alcohol use disorders, ensuring that healthcare systems are equipped to provide effective support. Another core strategy is enforcing comprehensive bans or restrictions on alcohol advertising, sponsorship, and promotion to minimize its influence, particularly on vulnerable populations such as youth. Finally, the initiative advocates raising alcohol prices through excise taxes and pricing policies to make it less affordable and thereby reduce consumption.
By implementing these evidence-based, cost-effective measures, the SAFER initiative aims to reduce the global burden of alcohol-related deaths and disabilities, fostering healthier societies worldwide.
more
The "Regional Action Plan 2017–2030: Towards a Malaria-Free South-East Asia Region" by the World Health Organization (WHO) outlines a strategic framework to eliminate malaria in the 11 countries of the WHO South-East Asia Region by 2030. It focuses on reducing transmission, particularly of Plasmod...ium falciparum and P. vivax, addressing multidrug resistance, improving surveillance, and ensuring universal access to diagnosis, treatment, and prevention. The plan sets clear objectives and milestones and emphasizes strong governance, cross-border collaboration, community involvement, and sustainable financing to achieve and maintain a malaria-free status across the region.
more
The Consensus Statement on c-IPTp is a publication by the RBM Partnership to End Malaria. It focuses on community-based intermittent preventive treatment in pregnancy (c-IPTp), aiming to enhance malaria prevention among pregnant women through community-level interventions. The statement offers po...licies, recommendations, and joint statements to guide the implementation of c-IPTp strategies. The document is available for download in English, French, and Portuguese.
more
The WHO guidelines for malaria bring together the Organization’s most up-to-date recommendations for malaria in one user-friendly and easy-to-navigate online platform.
The WHO guidelines for malaria bring together the Organization’s most up-to-date recommendations for malaria in one user-frie...ndly and easy-to-navigate online platform. The Guidelines supersedes 2 previous WHO publications: the Guidelines for the treatment of malaria, third edition and the Guidelines for malaria vector control. Recommendations on malaria will continue to be reviewed and, where appropriate, updated based on the latest available evidence. Any updated recommendations will always display the date of the most recent revision in the MAGICapp platform. With each update, a new PDF version of the consolidated guidelines will also be available for download on the WHO website.
This version of the Guidelines includes an updated recommendation for malaria vaccines, new recommendations on the use of near-patients qualitative and semiquantitative G6PD tests to guide anti-relapse treatment of P. vivax and P. ovale, updated recommendations on primaquine and the recommendation on the use of tafenoquine. It replaces the versions published on 16 February 2021, 13 July 2021, 18 February 2022, 31 March 2022, 3 June 2022, 25 November 2022, 14 March 2023 and 16 October 2023.
more
his guidance details basic decontamination principles and procedures that should be followed to decontaminate the physical environment in the context of the coronavirus disease 2019 (COVID-19) pandemic. Surface contamination and transmission risk all differ by the type of setting and the volume of p...eople that frequent each setting (e.g. healthcare facilities, public transport, and other busy facilities/workplaces), even though the principles of environmental decontamination remain the same.
more
The "Integrated Management of Malaria Training – Health Worker’s Manual" is a practical guide developed by Uganda’s Ministry of Health to train healthcare workers at all levels in the effective diagnosis, treatment, prevention, and management of malaria. It aligns with national malaria treatme...nt guidelines and aims to improve the quality of care and reduce malaria-related illness and death. The manual covers key topics such as clinical assessment of fever, use of rapid diagnostic tests (RDTs), case management of uncomplicated and severe malaria, malaria in pregnancy, co-infections like HIV, as well as community engagement and proper documentation. It includes structured training sessions, case studies, and job aids designed to strengthen the skills of health workers in both public and private sectors, and to ensure standardized, evidence-based malaria care across the country.
more
This guidance will assist the transportation sector, including transport authorities, companies, independent or informal drivers, and passengers, in addressing coronavirus disease 2019 (COVID-19) for different outbreak phases as defined in the Africa CDC Stepwise Response.
This guidance complements... the Africa CDC Guidance for Community Physical Distancing, which includes further details on how to engage communities, implement physical distancing, and support organisations, and the Africa CDC Guidance for Community Use of Face Masks.
more
The National Malaria Elimination Strategic Plan (NMESP) 2024–2028 of Ghana outlines the country’s roadmap to shift from malaria control to elimination. Despite major progress—like reducing malaria deaths from nearly 2,800 in 2012 to 151 in 2022—malaria remains a major public health challenge... in Ghana.
The plan aims to reduce malaria deaths by 90% and cases by 50% by 2028 (compared to 2022), and to eliminate malaria entirely in 21 low-burden districts. It includes a mix of interventions such as insecticide-treated nets, indoor residual spraying, seasonal chemoprevention, malaria vaccination, and strong surveillance systems.
The strategy is tailored to the local malaria burden, promotes community engagement, relies on multisectoral partnerships, and ensures adequate resource mobilization. Its ultimate goal is to protect Ghana’s population, improve public health, and support the country’s socioeconomic development.
more
Hypertension, or high blood pressure, is a condition which generally has no symptoms and if left untreated, can lead to heart attacks, heart failure, stroke, kidney failure and blindness. Risk factors include older age, overweight or obesity, lack of physical activity, high salt/sodium intake, and h...igh alcohol intake.
Hypertension affects around 1 in 6 adults in the Americas and is the main risk factor for cardiovascular diseases, which are the leading cause of death in the region, responsible for around 2 million lives lost each year.
more
The COVID-19 pandemic has affected everyone, including key populations at higher risk of HIV. And the gains made against other infectious diseases, including HIV, are at risk of being reversed as a result of disruptions caused by COVID-19. This is the background to a new report published by FHI 360,... in collaboration with UNAIDS, which gives advice on how to minimize the impacts of COVID-19 on key populations.
more
Chronic respiratory diseases, such as asthma and
chronic obstructive pulmonary disease, kill more than
four million people every year and affect hundreds
of millions more. These diseases erode the health
and well-being of the patients and have a negative
impact on families and societies. Women ...and
children are particularly vulnerable, especially those
in low and middle income countries, where they are
exposed on a daily basis to indoor air pollution from
solid fuels for cooking and heating. In high income
countries, tobacco is the most important risk factor
for chronic respiratory diseases, and in some of
these countries, tobacco use among women and
young people is still increasing.
more
This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector development plans and the Health Sector Reform Strategy ...2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
more
Epidemiology, Control, and Financing
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
more