Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati...ve to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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In the event of an accident or medical emergency, First Aid saves lives. Keeping the patient alive and safe until the arrival of expert professional help is a vital part of the chain of care which leads to recovery. The principle of First Aid must be simple skills, clearly taught and capable of bein...g performed in a stressful situation by those with no medical training. This manual is intended to offer a basic level of First Aid for members of the general public.
The contents of this manual are offered as a first edition of European First Aid Guidelines for general use. As such they are compatible with current practise, with other specialist guidelines (for example regarding the management of burns) and with the evidence base where one exists. These guidelines will be updated on a regular basis by the JOIN Clinical Working Group.
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In recent years, high prices of pharmaceutical products have posed challenges in high- and low-income countries alike. In many instances, high prices of pharmaceutical products have led to significant financial hardship for individuals and negatively impacted on healthcare systems’ ability to prov...ide population-wide access to essential medicines.
Pharmaceutical pricing policies need to be carefully planned, carried out, and regularly checked and revised according to changing conditions. Strong, well-thought-out policies can guide well-informed and balanced decisions to achieve affordable access to essential health products.
This guideline replaces the 2015 WHO guideline on country pharmaceutical pricing policies, revised to reflect the growing body of literature since the last evidence review in 2010. This update also recognizes country experiences in managing the prices of pharmaceutical products.
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Millions of children in Yemen could be pushed to ‘the brink of starvation’ due to huge shortfalls in humanitarian aid funding amid the COVID-19 pandemic – according to a new UNICEF report marking more than five years since conflict escalated in the country.
Thirty years ago, the United Nations General Assembly adopted the Convention on the Rights of the Child at a moment of rapid global change marked by the end of apartheid, the fall of the Berlin Wall and the birth of the World Wide Web. These developments and more brought momentous and lasting evolut...ion, as well as a sense of renewal and hope for future generations. In a reflection of that hopeful spirit, the Convention has since become the most widely ratified human rights treaty in history.
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This document describes the key areas that national governments should consider for the introduction and scale-up of point-of-care (POC) diagnostics within national programmes, as new innovative POC technologies are being introduced into the market. The next steps taken to include these new innovati...ons within the broader context of national diagnostic networks of conventional laboratories could influence the achievement of the 2030 Fast Track targets for ending the AIDS epidemic.
POC diagnostics, when strategically introduced and integrated into national diagnostic networks, may help catalyse changes that improve the way diagnostics and clinical services are delivered. This document distils this understanding based on programmatic and market experiences of introducing POC diagnostics through catalytic investments in POC HIV technologies across numerous countries in sub-Saharan Africa.
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Overview: Risk communication and community engagement are essential for any disease outbreak response. This is particularly critical during outbreaks of Ebola which may create fear in the public and frontline responders alike due to severe presentation of symptoms, misunderstanding of the causes of ...illness and high fatality rates. This document outlines some of the key considerations for risk communication and community engagement response to Ebola outbreak in Democratic Republic of the Congo.
Ebola outbreaks have been associated with misinformation and false rumours. In the context of RCCE, rumours refer to unsubstantiated information, claims or beliefs about what is causing the disease or how it can be treated/cured. If not proactively addressed in culturally appropriate ways, misinformation and rumours can lead to the further rapid spread of the disease and unnecessary deaths, severe disease, suffering, and societal and economic loss.
The publication includes a 'Rumour Tracking Tool' (Annex II).
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Stories of how people in Georgia, Laos, Sri Lanka, Tajikistan and Vietnam made inclusive development happen in their societies. It contains significant experiences andlessons learnt about the practice of inclusive development for a wide range of excluded or marginalised groups, useful for policy-mak...ers, programme designers, local authorities, development practitioners and community leaders alike.
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Prepared as an outcome of ICMR Subcommittee on Gastric Cancer | This consensus document on Management of Gallbladder cancers summarizes the modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and molecular markers and research questions. It also ...interweaves clinical, biochemical and epidemiological studies.
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With hundreds of illustrations and clear instructions, A Community Guide to Environmental Health helps health promoters, development workers, environmental activists, and community leaders take charge of their environmental health in villages and cities alike. Also available in Arabic, Spanish, Chin...ese, Portuguese, Turkish, Dari, Malayan, Mongolian and Russian.
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NEUROLOGY ATLAS presents for the first time, the most
comprehensive collection and compilation of information on
neurological resources across 109 countries. The results confirm
that the available resources including services for neurological
disorders are markedly insufficient; in addition, the...re are large
inequities across regions and income groups of countries.
Urgent action is required to enhance the resources available
to address the increasing burden of neurological disorders.
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This global guidance provided the framework for over 100 countries to develop their NDVPs. This updated (second) version supersedes the previous version published in 16 November 2020. New information has been added on the following areas:
the COVID-19 Partners Platform;
the use of COVID...-19 simulation exercises to test deployment strategies;
the indemnity agreement and no-fault compensation programme for vaccines secured through the COVAX Facility in the Advance Market Commitment (AMC) eligible economies;
the availability and use of the WHO-UNICEF COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool;
the COVAX Facility’s humanitarian buffer that enables allocation of vaccine to cover high-risk populations in humanitarian settings;
recommendations for vaccination of pregnant and lactating women;
supplementary information on infection prevention and control (IPC) measures to be used to deliver COVID-19 vaccines safely;
the WHO licensed COVID-19 vaccines product-specific information;
use of geospatial data and digital micro plans for equitable access and delivery of COVID-19 vaccines;
lessons learned from the development of NDVPs and early experiences in COVID-19 vaccine deployment in countries; and
updated additional resources at the end of each chapter.
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Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t...echnologies to manage CVD disease must be available where and when they are required. Medicines and technologies need to be managed appropriately to ensure that the correct medicines are selected, procured in the right quantities, distributed to facilities in a timely manner, and handled and stored in a way that maintains their quality. This needs to be backed up by policies that enable sufficient quantities to be procured in order to reduce cost inefficiencies, ensure the reliability and security of the distribution system, and encourage the appropriate use of these health products. In order to avoid stock-outs and the disruption of treatment, all related activities need to be conducted in a timely manner, with performance continually monitored, and prompt action taken in response to problems that may arise. Additionally, medication must be dispensed correctly and used rationally by the healthcare provider and patient alike. The purpose of this guide is to explain the necessary steps.
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Securing a minimum of financial resources permitting to bring the full range of critical health services to all people constitutes a fundamental human right and an indispensable condition for human dignity. The model outlined here demonstrates that it is within our reach to close the financing gap e...ven for the poorest countries by 2020 if all governments, from the privileged and underprivileged parts of the world alike, just fulfil the commitments and recommendations for financing human development and health that already were agreed many years ago.
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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.
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The World Health Organization (WHO) and the global community of countries, partners, donors, technical experts, scientists and field implementation teams continue to work towards the ultimate goal of a world free of the burden of neglected tropical diseases (NTDs). This work is described in the NTD ...road map 2021–2030, WHO’s blueprint to drive global efforts in the fight against NTDs in the context of the United Nations Sustainable Development Goals. These goals encompass a vision of a world population for whom equality of opportunity and of health are fundamental.
Within this context, and during the two years since the launch of the road map (2021–2022), progress has been made. Nevertheless, hindrances towards achieving the targets for 2030 have arisen and work to overcome these obstacles continues. These endeavours have also revealed the scale of the task still facing the global NTD community.
Disruption as a result of the COVID-19 pandemic has continued to afflict longstanding and new programmes alike, while other entrenched issues have re-emerged in new and challenging ways. The global NTD community is also confronted with a changing, multi-dimensional funding landscape as donors reassess priorities and adapt to new ways of working, as well as a challenging and unpredictable international context. As a result, progress in controlling, eliminating or eradicating NTDs has not been as far-reaching as expected.
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mnesty International’s annual report on the state of the world’s human rights in 2021, published in March 2022, shows that promises to “build back better” after the Covid-19 pandemic were little more than lip service. Hopes of global cooperation withered in the face of vaccine hoarding and c...orporate greed.
Governments suppressed independent and critical voices, with some even using the pandemic as a pretext to shrink further the civic space. New and unresolved conflicts erupted or persisted. Those forced to flee were subjected to a litany of abuses, including pushbacks by countries in the Global North. But hopes for a better post-pandemic world were kept alive by courageous individuals, social movements and civil society organizations.
The report is available in different languages
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“Because we struggle to survive” Child Labour among Refugees of the Syrian Conflict | This study provides pertinent first-hand information on the reality facing Syrian children who are working either in their homeland, the neighbouring countries or elsewhere in Europe. Syria's civil war is the w...orst humanitarian crisis of our time. Hundreds of thousands of people - adults and children alike - have been killed. Two thirds of all Syrians have lost their homes and their livelihoods. Millions of Syrians have been uprooted from their home communities and forced to flee within their country or to neighbouring countries. The consistent spill-over has drawn global attention not just to the humanitarian crisis facing both local communities and national governments but also to the economic and social strain. The bloodshed wreaked by the different parties continues. The suffering deepens. Approximately half of the Syrian refugees and displaced persons are children and young people who suffer from a double-vulnerability: as children and as migrants or refugees.
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PQM conducted an assessment of the medicine quality assurance and quality control systems in Rwanda during November 9-13, 2009. Medicine quality assurance remains to be developed in Rwanda: the country has neither a medicine regulatory authority (MRA) nor a national medicine quality control laborato...ry – the two key institutions to ensure the quality, safety, and efficacy of medicines. The MOH Pharmacy Taskforce (PTF) is to be commended however for successfully controlling the pharmaceutical market to the extent that there is no informal medicines market in Rwanda. Based on its findings, the assessment team expects Rwanda to be able to make great strides in evidence-based medicines quality assurance in the short to medium term, provided it receives adequate technical assistance and financial support.
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This important issue of Forced Migration Review draws our attention to the current challenges facing displaced Syrians and the continuing search for solutions. The statistics of Syrian displacement are staggering – and the numbers continue to rise. Half of Syria’s population has been displaced: ...five and a half million are registered refugees and over six million are internally displaced.
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