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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp
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onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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The coronavirus disease 2019 (COVID-19) pandemic has created a global and gendered crisis that is compounding existing inequalities and disproportionately affecting girls and women. Emerging evidence from the COVID-19 crisis in 2020 shows school closures, disruptions in essential services and rising
...
poverty contributed to girls’ increased risk of female genital mutilation (FGM). School closures limited the monitoring and reporting of cases of FGM. Rising household monetary poverty may have contributed to families adopting negative coping mechanisms, including having girls undergo FGM as a precursor to marriage to reduce household costs. A report from the United Nations Population Fund (UNFPA) estimates 2 million additional cases of FGM by 2030 due to the pandemic.
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In 2015, to advance the global and national response to antimicrobial resistance (AMR), the World Health Assembly issued resolution WHA68.7 calling for all Member States to develop AMR national action plans that address the five objectives of the World Health Organization Global Action Plan (GAP) by
...
May 2017. The WHO GAP provides a framework to support countries in developing their national action plans on AMR. To operationalize and accelerate implementation of national action plans on AMR, WHO has developed a costing and budgeting tool and accompanying user guide. The purpose is to support countries in costing prioritized activities of an operational plan linked to their AMR national action plan, and identify existing funding and funding gaps to promote resource mobilization and sustainable implementation. The target audience of the publication are national policy makers and designated costing coordinators for national action plans on AMR.
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This report is the first of its kind. It brings together various data sets to present the current status of hand hygiene, highlight lagging progress, and call governments and supporting agencies to action, offering numerous inspiring examples of change.
During the COVID-19 pandemic, hand hygiene
...
received unprecedented attention and became a central pillar in national COVID prevention strategies. However, concern with hand hygiene should not only be as temporary public health measure in times of crisis, but as a vital everyday behaviour that contributes to health and economic resilience. Hand hygiene is a highly cost-effective investment, providing outsized health benefits for relatively little cost.
Despite efforts to promote hand hygiene, the rates of access to hand hygiene facilities remain stubbornly low. If current rates of progress continue, by the end of the SDG era in 2030, 1.9 billion people will still lack facilities to wash their hands at home.
This report presents a compelling case for investment in five key ‘accelerators’ as a pathway towards achieving hand hygiene for all – governance, financing, capacity development, data and information, and innovation. These accelerators are identified under the UN-Water SDG 6 Global Acceleration Framework.
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Guidelines for the production of extemporaenous formulations and hospital based sterile preparations
In order to streamline and effectively control compounding of medicinal products in hospitals and pharmacies, these Guidelines for Production of Extemporaneous and Hospital Based Sterile Preparations has been crafted. The purpose of these guidelines therefore is to assist pharmacists in
...
discharging their legal and professional obligations to patients in the area of extemporaneous dispensing. This guidance will help to assure the safe and appropriate preparation and supply of extemporaneously prepared medicinal products to patients, where
the supply of such products is necessary.
Extemporaneous and hospital based sterile preparations are critical for patients whose clinical needs cannot be met by registered medicinal products. The guidelines outline the principles and application of the concepts of Good Manufacturing Practice (GMP) requirements for premises, equipment, personnel, storage, quality management system, quality control, compounding processes as well as documentation.
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The WHO End TB Strategy aims to end the global TB epidemic by 2030, in alignment with Goal 3 of the United Nations (UN) Sustainable Development Goals (SDGs). Member States of the World Health Organization (WHO) and the UN committed to ending the TB epidemic through adoption of WHO’s End TB Strateg
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y and the UN SDGs in 2014 and 2015, respectivel
Almost half of the deaths worldwide caused by TB in 2019 occurred in the WHO South-East Asia Region, home to around a quarter of the global population. Maintaining robust progress in this Region is therefore essential if the global goal of ending the TB epidemic is to be realized. Despite substantial gains made in the Region, the threat to
health worldwide posed by the COVID-19 pandemic has the potential to reverse these gains and eclipse the focus on the global TB emergency.
While continuing to tackle COVID-19-related challenges, countries will need to rapidly and urgently deploy supplementary measures to address the large numbers of missed cases, poor treatment outcomes and, potentially, a higher TB burden.
The Regional Strategic Plan towards Ending TB in the Region 2021–2025 clearly articulates priority interventions, analyses the challenges, bottlenecks and opportunities, and focuses on implementation considerations in the Region.
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This document synthesizes key elements of the World Health Organization (WHO) normative guidance on health policy and system support for community health worker (CHW) programmes and their application for HIV programmes. Building on relevant elements of HIV guidelines, tools and evidence identified b
...
y experts, it provides recommendations on tasks and roles that can be performed by CHWs (including for HIV), identifies the policy and system supports to optimize CHW performance, and gives examples of best practice. Its purpose is to inform the optimal design and delivery of CHW programmes targeting – either specifically or as part of a broader approach – the scale-up and sustainability of HIV services.
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Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal
...
ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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3rd edition. In 2001, Uganda adapted the Integrated Disease Surveillance and Response (IDSR) developed by World Health Organization (WHO) for member states in African region. The Ministry of Health has been implementing the IDSR strategy since then with success across the country. This strategy prov
...
ides the opportunity for rational use of resources and maximises investments in health surveillance systems. The 3rd edition IDSR guidelines incorporates lessons learnt from previous
epidemics, new frameworks like the Global Health Security Agenda (GHSA), One Health, Disaster Risk Management (DRM), the WHO regional strategy for health security and emergencies, and the rising non-communicable diseases, and aims to strengthen implementation of IHR (2005) core surveillance and response capacities. These guidelines have been adapted to reflect national priorities, policies and public health structures; and shall be used in conjunction with other similar
guidelines/strategies or initiatives.
Overall, the 3rd edition technical guidelines will incorporate the following:
• Strengthening Indicator Based Surveillance
• Strengthening Event Based Surveillance
• Improving community-based disease surveillance
• Improving Cross Border Surveillance and response
• Scaling up e-IDSR implementation
• Improving reporting and information sharing platforms
• Improved data sharing across sectors
• Tailoring IDSR to Emergency or Disaster contexts
The 3rd edition guidelines are intended for use as:
• A general reference for surveillance activities across all levels
• A set of definitions for thresholds that trigger some action for response
• A stand-alone reference for level-specific guidelines on surveillance and response
• A resource for developing training, supervision and evaluation of surveillance activities
• A guide for improving early detection and preparedness for outbreak response.
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The Knowledge Guide provides guidance on how health workers can apply the Standards to their own practice. For each of the nine competencies and their specific behaviours in the Standards, the Knowledge Guide examines in detail how a health worker's knowledge, skills and attitudes can reach the stat
...
ed benchmark for providing people-centred health services to refugees and migrants. The Knowledge Guide also details the learning outcomes that reflect the behaviours that a health worker will demonstrate once they have achieved the Competency Standards.
The Knowledge Guide is designed for educators and health workers to assist in designing or integrating learning content to enable attainment of the identified knowledge, skills and attitudes.
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The report offers a snapshot of the drivers behind the persistent exclusion of persons with disabilities and proposes a framework to build an actionable agenda building on promising practices available in the region. The COVID-19 pandemic has laid bare the urgent need to build more inclusive and res
...
ilient societies. The region has shown its resilience in recovering from many crises in the past. Today, we are at a crucial flection point where it is clear that universal policies and economic growth alone are insufficient to eradicate the remaining pockets of exclusion. A disability-inclusive recovery should be at the core of the region’s rebuilding strategy. This matters in its own right but is also of utmost importance for the sustainability of the region.
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This document focus on the direct consequences of the virus (morbidity and mortality) in specific populations and on the results of measures aimed at mitigating the spread of the virus, with indirect impacts on socio-economic conditions. In this complex scenario, the gender approach has not received
...
due attention during the pandemic. Gender is one of the structural determinants of health, but it does not appear in analyses of the direct and indirect effects of the pandemic, despite being essential in the recognition and analysis of the differential impacts on men and women and their interaction with the different determinants of health.
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