Rabies is a neglected zoonotic disease with a global burden of approximately 59,000 human deaths a year. Once clinical symptoms appear, rabies is almost invariably fatal; however, with timely and appropriate post-exposure prophylaxis (PEP) consisting of wound washing, vaccine, and in some cases rabi...es immunoglobulin (RIG), the disease is almost entirely preventable. Access to PEP is limited in many countries, and when available, is often very expensive.
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WHO strongly recommends discontinuation of the nerve tissue vaccine, and replacement with modern concentrated and purified cell culture derived vaccines (CCDV) and embryonated eggbased rabies vaccines.
These vaccines must comply with WHO criteria for potency and innocuity following satisfactory ass...essment in humans during well-designed field trials
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This technical brief aims to support these trends, accelerated by the COVID-19 pandemic, and improve PrEP uptake, persistence, and effective use by providing implementation guidance for differentiated and simplified service delivery. The brief aims to support a range of stakeholders in planning and ...implementing PrEP services and supplements and updates previously published WHO PrEP implementation guidance.
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This document provides guidance on how to implement contact screening and chemoprophylaxis with single-dose rifampicin. The contents are logically ordered: counselling and obtaining consent, identification and listing of index case, listing of contacts, tracing of contacts, screening of contacts, ad...ministration of prophylactic drugs. Managerial aspects to undertake contact screeninig and chemoprophylaxis are also elaborated, including planning , training , supervision and drug management.
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WHO recommends that pre-exposure prophylaxis (PrEP) be offered as an additional prevention choice for HIV-negative individuals at substantial risk of HIV infection as part of combination prevention approaches.
HIV drug resistance has been rarely reported among PrEP users who tested HIV positive i...n randomized controlled trials or open-label studies. However, PrEP-selected HIV drug resistance could potentially negatively impact the effectiveness of treatment options among PrEP users who acquire HIV, since there is a potential for overlapping resistance profiles between antiretroviral drugs used for both PrEP and first-line antiretroviral therapy.
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Module 5
Monitoring and Evaluation
October 2018
Module 5: Monitoring and evaluation. This module is for people responsible for monitoring PrEP programmes at the national and site levels. It provides information on how to monitor PrEP for safety and effectiveness, suggesting core and additiona...l indicators for site-level, national and global reporting.
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Module 12:
Adolescents and young adults
July 2018
Module 12: Adolescents and young adults. This module is for people who are interested in providing PrEP services to older adolescents and young adults who are at substantial risk for HIV. It provides information on: factors that influence HIV... susceptibility among young people; clinical considerations for safety and continuation on PrEP; ways to improve access and service utilization; and inclusive monitoring approaches to improve the recording and reporting of data on young people.
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Module 2
Community Educators and Advocates
July 2017
Module 2: Community educators and advocates. Community educators and advocates are needed to increase awareness about PrEP in their communities. This module provides information on PrEP that should be considered in community-led activities ...that aim to increase knowledge about PrEP and generate demand and access.
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Module 1
Clinical
July 2017
Module 1: Clinical. This module is for clinicians, including physicians, nurses and clinical officers. It gives an overview of how to provide PrEP safely and effectively, including: screening for substantial risk of HIV; performing appropriate testing before initi...ating someone on PrEP and while the person is taking PrEP; and how to follow up PrEP users and offer counselling on issues such as adherence.
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Module 3
Counsellors
July 2017
Module 3: Counsellors. This module is for staff who counsel people as they consider PrEP or start taking PrEP and support them in coping with side-effects and adherence strategies. Those who counsel PrEP users may be lay, peer or professional counsellors and hea...lthcare workers, including nurses, clinical officers and doctors.
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Module 4
Leaders
July 2017
Module 4: Leaders. This module aims to inform and update leaders and decision-makers about PrEP. It provides information on the benefits and limitations of PrEP so that they can consider how PrEP could be effectively implemented in their own settings. It also contai...ns a series of frequently asked questions about PrEP.
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Module 6
Pharmacists
July 2017
Module 6: Pharmacists. This module is for pharmacists and people working in pharmacies. It provides information on the medicines used in PrEP, including on storage conditions. It gives suggestions for how pharmacists and pharmacy staff can monitor PrEP adherence... and support PrEP users to take their medication regularly.
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Module 8
Site Planning
July 2017
Module 8: Site planning. This module is for people involved in organizing PrEP services at specific sites. It outlines the steps to be taken in planning a PrEP service and gives suggestions for personnel, infrastructure and commodities that could be considered... when implementing PrEP.
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Module 9
Strategic planning
July 2017
Module 9: Strategic planning. As WHO recommends offering PrEP to people at substantial HIV risk, this module offers public health guidance for policy-makers on how to prioritize services, in order to reach those who could benefit most from PrEP, and in wh...ich settings PrEP services could be most cost-effective.
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Module 10
Testing providers
July 2017
Module 10: Testing providers. This module is for people who provide testing services at PrEP sites and laboratories. It offers guidance in selecting testing services, including screening of individuals before PrEP is initiated and monitoring while they ar...e taking PrEP. Information is provided on HIV testing, creatinine, HBV and HCV, pregnancy and STIs.
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Module 1q
PrEP users
July 2017
Module 11: PrEP users. This module provides information for people who are interested in taking PrEP to reduce their risk of acquiring HIV and people who are already taking PrEP – to support them in their choice and use of PrEP. This module gives ideas for cou...ntries and organizations implementing PrEP to help them develop their own tools.
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