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2
Cancer in sub-Saharan Africa
recommended
Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality.
Without rapid interventions, data estimates show a major increase in cancer mo
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rtality from 520 348 in 2020 to about
1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of
analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the
region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national
cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as
HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive,
and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed
by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial
investment is needed in developing cancer registries and cancer diagnostics for core cancer tests.
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Achieving the Sustainable Development Goals (SDGs) will require the international community to mobilize significant additional financing over the next decade. Tracking and analyzing this funding is central to measuring progress and making more informed choices to direct financial flows where they wi
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ll have the greatest impact. This brief highlights AidData’s updated methodology to track financing to the SDGs, providing a baseline of funding for the years immediately before and after their launch. To track SDG-related financing, we build on our 2017 pilot methodology. Using data from the OECD CRS database on all official development assistance between 2010 and 2016, we identify individual projects that are linked to specific SDG goals or targets and then quantify total financing by SDG. This brief highlights four countries that represent different development contexts and trajectories, exploring how a country’s individual context impacts its SDG-related donor funding by examining the composition of funding and financing trends. We also look at SDG financing from the perspective of donors to see how their own interests are reflected in development portfolios across different countries.
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Pathogen genomic surveillance has become a priority for public health systems in recent years. Genomic sequencing is increasingly being used to characterize pathogens and monitor important public health priorities (e.g. poliovirus, influenza virus, Mycobacterium tuberculosis and Vibrio cholerae, ant
...
imicrobial resistance (AMR)). The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the role that sequencing plays in the surveillance of infectious diseases. Sequencing facilitates earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution and tailored development and evaluation of interventions to inform local to global public health decision-making and action. However, there remains a need to coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data (GSD) with clinical and epidemiological data to strengthen its utility.
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Lessons learned from recent public health events such as the COVID-19 pandemic, Ebola virus disease, Zika virus disease outbreaks, and other public health threats, including earthquakes and floods, have highlighted the need for countries to continuously develop, strengthen, and maintain capacities r
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equired under the International Health Regulations (2005) (IHR (2005)).
Developing capacities for health security in a country requires the engagement of public and private entities across a broad range of sectors, including human and animal health, agriculture, environment, finance, security, emergency management, education, and transportation. The World Health Organization (WHO) is mandated through various resolutions, decisions, and reports of the World Health Assembly, and through the IHR (2005), to provide technical guidance and support to its Member States in developing, strengthening, and maintaining their health systems, including capacities required under the IHR (2005).
For countries to better prevent, prepare for, detect, notify, respond to, and recover from public health emergencies, they must build and maintain IHR core capacities and support the strengthening of health emergency prevention, preparedness, response, and resilience (HEPR) capacities. National Action Plans for Health Security (NAPHS), as capacity development plans, provide the tasks and resources needed to ensure adequate capacities are in place to prevent, detect, respond to, and recover from public health events in a sustainable manner. Investing in the resilience of these capacities within national health systems at national and local levels not only improves national health security but also helps safeguard economic, social, and political developments.
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Weekly epidemiological recordRelevé épidémiologique hebdomadaire 3 MAY 2024, 99th YEAR / 3 MAI 2024, 99e ANNÉE
No 18, 2024, 99, 203–224
The WHO position papers are concerned primarily with the use of vaccines in large-scale vaccination progr
...
ammes.
The position papers are intended for use by national public health officials and managers of immunization programmes.
This paper focuses on the second licensed dengue vaccine, TAK-003 (Qdenga, Takeda), along with WHO’s position for its use, and provides an update on the first licensed dengue vaccine, CYD-TDV.
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February 2020Earth's Future 8(2):e2019EF001377.The water planetary boundary attempts to provide a global limit to anthropogenic water cycle modifications, but it has been challenging to translate and apply it to the regional and local scales at which water problems and management typically occur. We
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develop a cross‐scale approach by which the water planetary boundary could guide sustainable water management and governance at subglobal contexts defined by physical features (e.g., watershed or aquifer), political borders (e.g., city, nation, or group of nations), or commercial entities (e.g., corporation, trade group, or financial institution).
more
Obesity and diet-related noncommunicable diseases (NCDs) have been steadily increasing globally, and with them, a pressing need to implement effective responses to address the contributing factors. Among the available evidence-based policy options that enable healthier choices and improved diets is
...
the implementation of taxes on sugar-sweetened beverages (SSBs).
This tax manual is a practical guide for policy-makers and others involved in SSB tax policy development to promote healthy diets and populations. It features summaries and case studies of SSB global taxation evidence, and provides support on the policy-cycle development process to implement SSB taxation — from problem identification and situation analysis through policy design, development and implementation to the monitoring and evaluation phase. Additionally, the manual identifies and debunks industry tactics designed to dissuade policy-makers from implementing these taxes.
SSB taxes can be a win-win-win strategy: a win for public health (and averted health-care costs), a win for government revenue, and a win for health equity.
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The environment in which young people live, learn and play significantly affects their decisions about whether to consume alcohol. Environmental factors are the main risk factors driving alcohol consumption and related harm among young people. Environments that normalize alcohol consumption – term
...
ed alcogenic environments – include contexts with unregulated advertising and marketing of alcoholic beverages, higher alcohol outlet density, products designed to facilitate affordability and low prices of alcoholic beverages. A recent body of research evidence has emerged related to the measurement, functional significance and consequences of living in alcogenic environments. This includes findings on the complex and bidirectional interactions among alcohol acceptability, availability and affordability and how they create and perpetuate alcogenic environments. Comprehensive and enforced alcohol control policies are effective at delaying the age of onset and lowering alcohol prevalence and frequency among young people. Evidence consistently confirms the effectiveness of designing and implementing alcohol control policies that regulate upstream the drivers of alcogenic environment, including alcohol availability, acceptability and affordability. These policies need to be multipronged and address the complex interactions between these drivers and the local alcohol culture
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Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris
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k factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now
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COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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Emergency medical teams (EMT) are first response health care providers – doctors, nurses, paramedics, and others – during outbreaks and emergencies or disasters, working with governments, charities such as nongovernmental organizations (NGOs), armies, and international organizations such as the
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International Red Cross/Red Crescent movement. They comply with the classification and minimum standards set by the World Health Organization (WHO) and its partners and bring to an emergency their training and self-sufficiency so as not to burden the national health system. EMT initiatives strengthen national surge capacities and facilitate the deployment of internationally classified teams of health- care professionals to countries and territories during emergencies, particularly during disease outbreaks and natural disasters, providing immediate assistance when national health systems are overwhelmed . Considering that they aim to support the provision of quality clinical care services to populations affected by public health emergencies, the expectation is that financial resources and equipment will be available to enable the performance of the requested task.
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As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive protection for individuals across the lifespan. By adopt
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ing a life course approach (LCA) to immunization, vaccination programs can be tailored to close immunity gaps at different stages of life. The life course approach foresees the establishment of multiple strategies to reduce missed opportunities for vaccination according to age group. This technical document explains the key concepts of the LCA with a focus on immunization by vaccination, as well as the underlying biological mechanisms that require the application different vaccines at different life stages according to changes to the immune system and in the epidemiological situation of a community.
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The paper “Artificial Intelligence for Public Health Surveillance in Africa: Applications and Opportunities” examines how artificial intelligence (AI) can improve public health systems across Africa, particularly in low-resource settings. It explores how machine learning and other AI techniques
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are being used for disease detection, outbreak prediction, real-time surveillance, and health resource management.
The authors focus on major public health challenges such as HIV, cholera, Ebola, measles, tuberculosis, malaria, COVID-19, and mental health. Through numerous case studies, the paper shows that AI can enhance the accuracy and speed of disease detection, predict outbreaks more effectively than traditional methods, support vaccination strategies, and optimize healthcare resource allocation. At the same time, it discusses important barriers to implementation, including limited data quality, infrastructure constraints, ethical concerns, and shortages of technical expertise.
Overall, the paper highlights AI’s strong potential to strengthen disease surveillance and health outcomes in Africa while emphasizing the need for careful integration, improved data systems, and supportive policy frameworks.
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The document is a practical toolkit that provides guidance for healthcare facilities on how to prepare for emergencies, including pandemics and other disasters. It explains how to conduct risk assessments using an all-hazards approach, helping facilities identify potential threats such as natural di
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sasters, technical failures, and disease outbreaks. The text outlines how to develop emergency preparedness and pandemic plans, including key elements like communication, staffing, resource management, and coordination with local, state, and federal authorities. It also describes the four phases of emergency management—mitigation, preparedness, response, and recovery—and emphasizes continuous evaluation and improvement. Overall, the document aims to help healthcare organizations ensure continuity of care and protect patients and staff during emergencies.
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ts goals are to ensure that:
Children and parents experience fewer conflicts;
Parents make better decisions about the care of their children and are better able to solve problems; and
Children feel more supported by their families t
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o further their education and make good decisions and healthy life choices.
This discussion guide is intended to facilitate discussion and peer learning, during which participants can learn from each other’s experiences and support each other. It is designed for group session discussions, as well as for one-on-one guidance in the home. It should be used with the "Better Parenting Nigeria" Facilitator’s Manual
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Project Paper to provide an additional grant for: Human Development Systems Strengthening Project (HDSSP)(P145965, H9360)
Policy Brief | April 2015 | This brief accompanies the data sheet, Addressing Risk Factors for Noncommunicable Diseases Among Young People in Africa: Key to Prevention and Sustainable Development, and its data appendix, which provide all available country-specific data on four key NCD risk factors a
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mong young people in Africa since 2004. These publications extend an earlier publication, Noncommunicable Disease Risk Factors Among Young People in Africa: Data Availability and Sources. All are available at www.prb.org/Publications/Datasheets/2015/ncd-risk-youth-africa.aspx.
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HIV Prevalence Patterns by Age and sex: Exploring Differences among 19 Countries
Chaitra Gopalappa, John Stover & Carel Pretorius
ICF International Calverton, Maryland, USA
(2013)
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DHS Analytical Studies No. 40
