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Publication Years
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Category
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Toolboxes
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1
Cardiovascular diseases (CVD) represent the highest burden of disease globally. Medicines are a critical intervention used to prevent and treat CVD. This review describes access to medication for CVD from a health system perspective and strategies t
...
hat have been used to promote access, including providing medicines at lower cost, improving medication supply, ensuring medicine quality, promoting appropriate use, and managing intellectual property issues. Using key evidence in published and gray literature and systematic reviews, we summarize advances in access to cardiovascular medicines using the 5 health system dimensions of access: availability, affordability, accessibility, acceptability, and quality of medicines. There are multiple barriers to access of CVD medicines, particularly in low- and middle-income countries. Low availability of CVD medicines has been reported in public and private healthcare facilities. When patients lack insurance and pay out of pocket to purchase medicines, medicines can be unaffordable. Accessibility and acceptability are low for medicines used in secondary prevention; increasing use is positively related to country income. Fixed-dose combinations have shown a positive effect on adherence and intermediate outcome measures such as blood pressure and cholesterol. We have a new opportunity to improve access to CVD medicines by using strategies such as efficient procurement of low-cost, quality-assured generic medicines, development of fixed-dose combination medicines, and promotion of adherence through insurance schemes that waive copayment for long-term medications. Monitoring progress at all levels, institutional, regional, national, and international, is vital to identifying gaps in access and implementing adequate policies.
more
INTRODUCTION: Lower extremity peripheral artery disease (PAD) is increasing in prevalence in low- and middle-income countries creating a large health care burden. Clinical management may require substantial resources but little consideration has been given to which treatments are appropriate for les
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s advantaged countries.
EVIDENCE ACQUISITION: The aim of this review was to systematically appraise published data on the costs and effectiveness of PAD treatments used commonly in high-income countries, and for an international consensus panel to review that information and propose a hierarchy of treatments relevant to low- and middle-income countries.
EVIDENCE SYNTHESIS: Pharmacotherapy for intermittent claudication was found to be expensive and improve walking distance by a modest amount. Exercise and endovascular therapies were more effective and exercise the most cost-effective. For critical limb ischemia, bypass surgery and endovascular therapy, which are both resource intensive, resulted in similar rates of amputation-free survival. Substantial reductions in cardiovascular events occurred with use of low cost drugs (statins, ACE inhibitors, anti-platelets) and smoking cessation.
CONCLUSIONS: The panel concluded that, in low- and middle-income countries, cardiovascular prevention is a top priority, whereas a lower priority should be given to pharmacotherapy for leg symptoms and revascularisation, except in countries with established vascular units.
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Factors to take into account when choosing, reviewing and changing medicines.
Rescue therapy:
For symptomatic hyperglycaemia, consider insulin or a sulfonylurea and review when blood glucose control has been achieved.
Diet and lifestyle advice:
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At each point reinforce advice about diet and lifestyle.
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This report is the first of a series of biennial progress reports on the implementation of the Global health sector strategies on HIV, viral hepatitis and sexually transmitted infections for the period 2022–2030. It draws attention to areas of progress and gaps in preparation for the mid-term
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review of the strategies in 2026.
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Exploring equity and inclusion in Malawi’s National Disability Mainstreaming Strategy and Implementation Plan
Ebuenyi, I.D.; Smith, E.M.; Munthali, A. et al.
International Journal for Equity in Health
(2021)
CC
Background
Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan.
Met
...
hods
We applied an analytical methodology to review the Malawi’s National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion.
Results
The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process.
Conclusions
The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production – co-implementation – co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.
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Diabetes is one of the leading causes of death globally. India is home to the second-largest population suffering from diabetes. This underscores the need to build capacity of primary care physicians (PCPs) for better disease management. This narrative rev
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iew article aims to describe the emergence of diabetes education and capacity-building programs for PCPs and its current situation in India. The review highlighted that major emphasis on diabetes was given only when the WHO estimated that morbidity and mortality due to diabetes would increase to 35% in India. As a result, National Diabetes Control Program was launched in 1987. Yet, very little attention was paid to diabetology in under-graduation. In the last decade, few public and private institutions have developed diabetes related capacity-building programs for PCPs independently or in collaborations. These programs include 16 fellowships, 4 diplomas, 12 certificate programs, and 6 other diabetes training programs, which have their own pros and cons. As medical science is changing rapidly, PCPs need to upgrade their skills and knowledge regularly to manage NCDs such as diabetes more effectively and efficiently. This can be possible only if scientific, evidence-based, and quality-oriented capacity-building programs are provided to the healthcare workforce.
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Chronic obstructive pulmonary disease in over 16s: non-pharmacological management and use of inhaled therapies
National Institute for Communicable Disease (NICE)
National Institute for Health and Care Excellence (NICE)
(2019)
CC2
The document provides a summary of recommendations for the non-pharmacological management of chronic obstructive pulmonary disease (COPD) and the use of inhaled therapies in individuals over 16, emphasizing confirmed diagnosis, treatment options, and regular
...
review of treatment effectiveness and inhaler technique.
more
People with asthma should be encouraged to take part in any sport they choose. If someone with asthma is having difficulty with sport, it means their asthma may not be under control. You will need to see your doctor to review your controller treatme
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nt and the way you use your medications in oder to allow you to live your life to the full with no limitations on activities or sport.
more
Overview and Practical Experiences from Ethiopia and Uganda. Slide set.
This webinar provides an overview of the new IEC & Social Mobilization NTD Tool Kit, which leads users through a step-by-step process to systematically review, revise, develop
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and adapt current IEC materials and social mobilization approaches towards stronger, evidence-based practices in support of positive behavior change for MDA programs in the control of NTDs. Experiences from Ethiopia and Uganda are shared.
more
Lancet. 2014 June 28; 383(9936): 2253–2264. doi:10.1016/S0140-6736(13)61949-2. Review Article
Malaria in pregnancy is a significant health problem in malaria-endemic areas. It not only causes substantial childhood morbidity and mortality but also increases the risks of adverse events for pregnant women and their developing fetuses. Most of the burden in these areas is due to infection with P
...
lasmodium falciparum. Artemisinin-based combination therapy (ACT) has been recommended as first-line treatment for uncomplicated P. falciparum malaria in all populations, including pregnant women in their second and third trimesters, since 2006. However, for women in their first trimester of pregnancy, WHO recommended as first-line treatment a combination of quinine and clindamycin.
Based on a review of the evidence conducted in 2022, WHO now recommends artemether–lumefantrine, the ACT with the most human safety data available, as the preferred treatment for uncomplicated P. falciparum malaria in the first trimester of pregnancy. This document presents all relevant evidence on the effects and safety in early pregnancy of artemisinins and partner medicines used in ACTs from both studies in experimental animals and observational studies in humans.
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The Strategic Malaria Communication Guide for Central America is intended to facilitate the shift from malaria control to elimination by strengthening communication and advocacy initiatives throughout the region. Based on interviews and a review of
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literature, the guide offers National Malaria Programmes (NMPs) recommendations on messaging, target audiences, communication channels and advocacy strategies. The guide's primary goals are to raise awareness of malaria elimination, encourage long-term commitment from decision-makers and mobilise sustainable resources. The guide outlines two strategic objectives: (1) creating a shared understanding of the long-term requirements for malaria elimination, including funding, surveillance and multi-sectoral engagement, and (2) expanding support among public, private and cross-sectoral stakeholders. With malaria cases having already reduced by 88% since 2000, the guide emphasises the importance of maintaining focus and investment in order to fully eliminate the disease and prevent its re-establishment in Central America.
Accessed on 10/06/2025.
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Malar J . 2025 Jan 5;24:1. doi: 10.1186/s12936-024-05235-z
This review examines the role of routine malaria vaccination in Africa as a key strategy toward malaria elimination, explores challenges and solutions for widespread vaccine implementation
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, and discusses future directions in the ongoing fight to eliminate malaria on the continent.
more
Poverty and associated health, nutrition, and social factors prevent at least 200 million children in developing countries from attaining their developmental potential. We review the evidence linking compromised development with modifiable biologica
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l and psychosocial risks encountered by children from birth to 5 years of age. We identify four key risk factors where the need for intervention is urgent: stunting, inadequate cognitive stimulation, iodine deficiency, and iron deficiency anaemia. The evidence is also sufficient to warrant interventions for malaria, intrauterine growth restriction, maternal depression, exposure to violence, and exposure to heavy metals. We discuss the research needed to clarify the effect of other potential risk factors on child development. The prevalence of the risk factors and their effect on development and human potential are substantial. Furthermore, risks often occur together or cumulatively, with concomitant increased adverse effects on the development of the world's poorest children.
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The emergence of SARS-CoV-2 has significantly altered the epidemiology of other infectious diseases, making investigations into its co-infection with malaria particularly relevant in endemic regions. This review examines the epidemiological, incubat
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ion and clinical features of the two diseases, highlighting the diagnostic challenges and strategies for accurate detection. Emerging immunological and genetic evidence indicates that prior exposure to malaria may reduce the severity of outcomes of SARS-CoV-2 infection through mechanisms involving ACE2 downregulation, TLR signalling, T-cell activation and upregulation of coinhibitory receptors. Additionally, potential control measures are discussed, including vaccine development, the repurposing of antimalarial drugs, the exploration of natural products, innovations in bioinsecticides, and the strengthening of electronic disease surveillance. These insights provide valuable guidance for clinical management and public health policy, while emphasising the need for continued research into the complex interactions between SARS-CoV-2 and malaria.
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During the reporting period, significant progress was made in strengthening the mpox response across the continent. The lessons learned and challenges identified during the joint mpox continental intra-action review (IAR), which took place successfu
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lly in December 2024 in Addis Ababa have guided the development of the action plan for the response to the mpox epidemic in January and February 2025.
more
International Journal for Parasitology: Drugs and Drug Resistance Volume 28, August 2025, 100602
This review provides innovative insights to circumvent antimalarial drug resistance and diversify malaria therapeutics.
This manual was developed based on the recommendations of a global technical consultation on child health in humanitarian emergencies co-organized by WHO and UNICEF at the end of 2003. WHO in collaboration with the Centre for Refugee and Disaster Response, Bloomberg School of Public Health, Johns Ho
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pkins University undertook a systematic review in 2004. It demonstrated that existing guidelines, including The Integrated Management of Childhood Illness (IMCI), do not cover all priority conditions in emergencies. The objective of this manual is to provide comprehensive guidance on child care in emergencies.
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hese are two parallel guidelines, one for small hospitals and another one for large hospitals. In view of heavy burden of malaria and prevalence of drug resistant falciparum malaria in the South-East Asia Region, the guidelines were developed for use by medical personnel who treat severe malaria pat
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ients, referred from lower-level health facilities. The guidelines were developed by the WHO Regional Office for South-East Asia and the WHO Collaborating Centre for the Clinical Management of Malaria, Faculty of Tropical Medicine, Mahidol University, Thailand. The guidelines are based on a review of current evidence, existing WHO guidelines and experience in the management of malaria in the Region
more
Regional Guidelines for the Management of Severe Falciparum Malaria in Small Hospitals
Polrat Wilairatana, Srivicha Krudsood, Ma. Sandra B. Tempongko et al.
WHO South-East Asia New Delhi
(2006)
C1
These are two parallel guidelines, one for small hospitals and another one for large hospitals. In view of heavy burden of malaria and prevalence of drug resistant falciparum malaria in the South-East Asia Region, the guidelines were developed for use by medical personnel who treat severe malaria pa
...
tients, referred from lower-level health facilities. The guidelines were developed by the WHO Regional Office for South-East Asia and the WHO Collaborating Centre for the Clinical Management of Malaria, Faculty of Tropical Medicine, Mahidol University, Thailand. The guidelines are based on a review of current evidence, existing WHO guidelines and experience in the management of malaria in the Region.
more
