The biennium 2020–2021 has revealed more clearly than ever the need for a strong, credible and independent WHO on the world stage. The coronavirus disease (COVID-19) crisis has demonstrated the fundamental importance of the global detection, response and coordination roles that only WHO can play a...cross all Member States. At the same time, the challenges to global health systems and the pressure to ensure equal access to quality health care and the best health possible for all have mounted. The triple billion targets of the Thirteenth General Programme of Work, 2019–2023 remain relevant. The work of WHO in all contexts has never been more critical. However, as several Member States have pointed out, the COVID-19 pandemic has highlighted the discrepancy between what the world expects of WHO and what it is able to deliver with the resources/capacity it has at its disposal. Sustainable financing is thus a key challenge for the Organization that must be addressed as part of the lessons learned from the current COVID-19 pandemic. Member States discussed this issue in detail during the Seventy-third World Health Assembly and their conclusions were reflected in resolution WHA73.1 (2020). The topic of adequate funding is not new. However, discussions on the matter have, to date, remained rather abstract. Building on previous discussions and taking account of lessons learned, the WHO Secretariat would like to initiate a process aimed at finding a concrete solution to the sustainable financing of WHO. This document proposes a process through which to arrive at such a decision, including the key stages and timeline.
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The Pandemic Influenza Preparedness (PIP) Framework is a World Health Assembly resolution adopted unanimously by all Member States in 2011. It brings together Member States, industry, other stakeholders and WHO to implement a global approach to pandemic influenza preparedness and response. The Frame...work includes a benefit-sharing mechanism called the Partnership Contribution (PC). The PC is collected as an annual cash contribution from influenza vaccine, diagnostic, and pharmaceutical manufacturers that use the WHO Global Influenza Surveillance and Response System (GISRS). Funds are allocated for: (a) pandemic preparedness capacity building; (b) response activities during the time of an influenza pandemic; and (c) PIP Secretariat for the management and implementation of the Framework.
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Background: Several countries allocate official development assistance (ODA) for research on global health and development issues that is initiated in the donor country. The integration of such research within domestic research systems aligns with efforts to coordinate ODA investments with science, ...technology and innovation policies towards achieving the Sustainable Development Goals (SDGs).
Methods: Through a document synthesis and interviews with research funders in ODA donor and recipient countries, we evaluated the performance of this funding approach across seven donor-country programmes from five donor countries and examined the institutional design elements that increase its chances of advancing development goals and addressing global challenges.
Results: We found that carefully designed programmes provide a promising pathway to producing valuable and contextually relevant knowledge on global health and development issues. To achieve these outcomes and ensure they benefit ODA-receiving countries, programmes should focus on recipient-country priorities and absorptive capacity; translate research on global public goods into context-appropriate technologies; plan and monitor pathways to impact; structure equitable partnerships; strengthen individual and institutional capacity; and emphasize knowledge mobilization.
Conclusions: Global health and development research programmes and partnerships have an important role to play in achieving the SDGs and addressing global challenges. Governments should consider the potential of ODA-funded research programmes to address gaps in their global health and development frameworks. In the absence of concrete evidence of development impact, donor countries should consider making increases in ODA allocations for research additional to more direct investments that have demonstrated effectiveness in ODA-receiving countries.
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A country’s ability to manage a crisis depends on its level of resilience. Efforts are made to clarify the concept of health system resilience, but its operationalisation remains little studied. In the present research, we described the capacity of the local healthcare system in the Islamic Republ...ic of Mauritania, in West Africa, to cope with the COVID-19 pandemic.
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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig...h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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Background
The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery to...wards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published.
Methods
We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries’ advancement towards global targets is constrained by their health system’s assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability.
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Issue Brief 33: Since 21 June 2023, 57 024 new cholera cases, including 399 new death have been reported worldwide (European Center for Disease Prevention and Control). In total, 25 countries have reported cases since the beginning of 2023. The major underlying causes of potential outbreaks are poor... environmental infastructure, lack of health care services, lack of save water and sanitation as well as increase population movement. Climate change becomes an additional trigger, as extreme climate events like cyclones,floods and droughts reduce access to clean water and create an ideal environment for cholera to thrive. The overall capacity to respond to the multiple outbreaks is obstructed by a global lack of resources.
This issue brief provides an overview of the current outbreaks, treatment guidelines, information material, countries strategies and more.
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Since the last situation report on the multi-country outbreak of cholera was published on 6 July 2023 (covering data reported until 15 of June), and as of 15 July 2023, one new outbreak of cholera was reported from India on 15 May 2023. In total, 25 countries have reported cases since the beginning ...of 2023. The WHO African Region remains the most affected region with 14 countries reporting cholera cases since the beginning of the year. The overall capacity to respond to the multiple and simultaneous outbreaks continues to be strained due to the global lack of resources, including shortages of the Oral Cholera Vaccine (OCV) and cholera supplies, as well as overstretched public health and medical personnel, who are dealing with multiple parallel disease outbreaks and other health emergencies. Based on the large number of outbreaks and their geographic expansion, as well as a lack of vaccines and other resources, WHO continues to assess the risk at global level as very high.
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This report started with a simple question—“How can we tell how much funding is devoted to global health programs?”—and ended (more than two years later) with an answer that is far from simple. As those who have tried know well, tracking health-related funding is challenging in any setting, ...given the range of public and private sources and the many types of services and programs that fall within the definition of “health sector.” It is made all the more complicated when significant external support from donors and private charities plus in-kind donations of drugs and other inputs are taken into account. The task is made yet harder by inadequate public expenditure management systems in countries where public agencies’ capacity is stretched very thin and by donor accounting structures that are not designed to respond in a timely way
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Since the last situation report on the multi-country outbreak of cholera was published on 1 June 2023 (covering data reported until 15 of May), no new country reported a cholera outbreak. In total, 24 countries have reported cases since the beginning of 2023. The WHO African Region remains the most ...affected region with 14 countries reporting cholera cases since the beginning of the year. The overall capacity to respond to the multiple and simultaneous outbreaks continues to be strained due to the global lack of resources, including shortages of the Oral Cholera Vaccine (OCV) and cholera supplies, as well as overstretched public health and medical personnel, who are dealing with multiple parallel disease outbreaks and other health emergencies. Based on the large number of outbreaks and their geographic expansion, as well as a lack of vaccines and other resources, WHO continues to assess the risk at global level as very high.
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The Africa Centres for Disease Control and Prevention (Africa CDC) Biosafety and Biosecurity Initiative was launched by the Africa CDC in April 2019 with the aim of strengthening the African Union (AU) Member States’ biosafety and biosecurity systems and enabling them to comply with national and i...nternational requirements for biosafety and biosecurity including the International Health Regulations (IHR) (2005), the Biological Weapons Convention (BWC), and United Nations Security Council Resolution (UNSCR) 1540 and the multi-country Global Health Security Agenda (GHSA). The World Health Organization (WHO) Joint External Evaluation (JEE) and the Global Health Security Index report confirmed the known capacity gaps in biosafety and biosecurity among Africa Union Member (AU).
The regional consultations by Africa CDC conducted between 2019-2021 highlighted the deficiency or limited availability of standardized and regionally recognized training programs in the continent, limiting biosafety and biosecurity capacity building efforts in the region. In response, Africa CDC working with AU Member States developed a home grown, implementable and accessible professional training and certification program that is both recognized and endorsed by AU Member States. The Regional Training and Certification Program for Biosafety and Biosecurity Professionals, for African Biosafety and Biosecurity Professionals (RTCP-BBP) has four (4) areas of specialization, namely
Selection, Installation, Maintenance and Certification of Biological Safety Cabinets
Biorisk Management
Design and Maintenance of Facilities Handling High Risk Pathogens (Biocontainment Engineering)
Biological Waste management
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The Africa Centres for Disease Control and Prevention (Africa CDC) Biosafety and Biosecurity Initiative was launched by the Africa CDC in April 2019 with the aim of strengthening the African Union (AU) Member States’ biosafety and biosecurity systems and enabling them to comply with national and i...nternational requirements for biosafety and biosecurity including the International Health Regulations (IHR) (2005), the Biological Weapons Convention (BWC), and United Nations Security Council Resolution (UNSCR) 1540 and the multi-country Global Health Security Agenda (GHSA). The World Health Organization (WHO) Joint External Evaluation (JEE) and the Global Health Security Index report confirmed the known capacity gaps in biosafety and biosecurity among Africa Union Member (AU).
The regional consultations by Africa CDC conducted between 2019-2021 highlighted the deficiency or limited availability of standardized and regionally recognized training programs in the continent, limiting biosafety and biosecurity capacity building efforts in the region. In response, Africa CDC working with AU Member States developed a home grown, implementable and accessible professional training and certification program that is both recognized and endorsed by AU Member States. The Regional Training and Certification Program for Biosafety and Biosecurity Professionals, for African Biosafety and Biosecurity Professionals (RTCP-BBP) has four (4) areas of specialization, namely
- Selection, Installation, Maintenance and Certification of Biological Safety Cabinets
- Biorisk Management
- Design and Maintenance of Facilities Handling High Risk Pathogens (Biocontainment Engineering)
- Biological Waste management
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South Sudan has a high burden – among the highest in sub-Saharan Africa – of neglected tropical diseases (NTDs). This adversely affects the health and social and economic well-being of people in the country. The prevention, control and eventual elimination of many NTDs depend heavily on improved... access to water, sanitation and hygiene (WASH) and, once there is access, on sound sanitation and hygiene practices. This is especially the case in NTD endemic communities.
The main NTDs prevalent in South Sudan include lymphatic filariasis, schistosomiasis (bilharzia), soiltransmitted helminths (STH), onchocerciasis, trachoma, leishmaniasis and Guinea-worm disease.
While the Ministry of Health (MoH) of South Sudan, through its NTD programme, had prioritized NTD/WASH partnerships and collaboration to improve the national NTD response, the programme lacked resources, capacity and a technical framework to lead the development of a harmonized NTD/WASH communication strategy.
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Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and comorbidities. Recognizing the significance of prim...ary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
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The recurrence of severe climate events combined with economic, social, and institutional fragilities leave El Salvador in an utterly critical humanitarian situation and highly vulnerable. Located in a disaster-prone subregion, El Salvador is among the 20 countries at the highest risk of disasters w...orldwide. The successive hydrometeorological hazards that impacted El Salvador over the past two years include tropical storms Amanda and Cristóbal and hurricanes Eta, Iota, and,
more recently, Julia. These storms profoundly affected the lives and livelihoods of almost 900 000 people and significantly disrupted health services, especially at the first level of care. In addition, the country’s exposure to earthquakes, floods, and droughts is also constant. Infrastructural and institutional limitations to deal with emergencies and
low capacity to respond to adverse events are an additional challenge, which leaves the population—particularly the most vulnerable—at even higher risk.
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For the past years, Haiti has been engulfed in a socioeconomic, political, and humanitarian crisis that has reached critical levels since mid-September 2022 with the intensification of gang violence and social unrest. The widespread insecurity and
political instability have drastically affected the... country’s access to essential goods and services, including food, water, and health. The current fuel supply crisis has affected the water and electricity supply to the population, health centers, and hospitals. Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services.
In parallel, the public health system and international partners face limited response capacity due to reduced international personnel in Haiti, logistics issues, and difficulties in importing supplies. Indeed insecurity, roadblocks, and lockdowns are affecting the importation of internationally procured goods, which may slow the arrival of essential lifesaving supplies to support cholera response efforts. This scenario is particularly problematic, as cholera recently resurfaced in early October.
Armed gangs now control over 60% of the metropolitan area of Port-au-Prince, affecting at least 1.5 million people, and have expanded their influence outside of the capital city, interrupting vital humanitarian programs in most of the national territory,
including COVID-19 vaccination campaigns.
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As part of the Mental Health Gap Action Programme, WHO has developed training manuals (Training of trainers and supervisors training manual and Training of health-care providers training manual) to support implementation of the mhGAP Intervention Guide for mental, neurological and substance use (MNS...) disorders in non-specialized health settings, version 2.0. These manuals can be used to build capacity among non-specialist health-care providers in the assessment and management of people with priority MNS conditions in low resource settings.
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It highlights the numerous challenges to quality service provision, along with the organisation’s response to mental health needs, and recommendations for international and regional decision-makers including:
- Advocating and working towards mental health policies that support adequate funding f...or mental health care and government suppor
- Legislation to protect the rights of people with mental disorders and vulnerable communities
- Advocating for multi-year funding to support the sustainability of MHPSS programs
- Creating capacity building opportunities consistent with the IASC guidelines and supported with continuous supervision
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This article considers the current public health perspective on cutaneous leishmaniasis (CL) and its implications for incidence, prevalence, and global burden of disease calculations. CL is the most common form of leishmaniasis and one of a small number of infectious diseases increasing in incidence... worldwide [1] due to conflict and environmental factors in the Middle East (“Old World”) and the Americas (“New World”)—regions where it is most prevalent.
Recently, the disease has reached hyperendemic levels in the conflict zones of the Syrian Arab Republic, Iraq, and Afghanistan while simultaneously affecting refugees from those regions . Nevertheless, CL is not seen as a priority for policymakers because it is not life limiting. This is evidenced by a lack of commitment in recent years to preventive campaigns and patient provision (limited diagnostic capacity, knowledge of treatment, drug availability) in a number
of endemic countries.
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