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The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The
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Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex. It also includes a summary of the countries health systems’ response to diabetes, including national plans, targets, surveillance, guidelines, and access to essential drugs and technologies, and synthesizes information about diabetes-related complications and the close relationship between diabetes and other pathologies, such as cardiovascular diseases, tuberculosis, and COVID-19. The data presented here reveal that, despite advances in national responses, diabetes continues to expand, and our response remains insufficient. This report aims to draw attention to the urgent need to strengthen efforts to prevent, diagnose, and control diabetes in the Region of the Americas.
more
Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal h
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ealth systems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
more
The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by
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countries and health systems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African cou
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ntries. We conducted focus group discussions (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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The Country Cooperation Strategy is the World Health Organization (WHO)’s reference for country work guiding planning and resource allocation through alignment with national health priorities and harmonization with other development partners. It c
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larifies roles and functions of WHO in supporting the national strategic plan for health through the Sector-Wide Approach and Malawi Growth and Development Strategy II. The Country Cooperation Strategy is based on a systematic assessment of the recent national achievements, emerging health needs,
challenges, government policies and expectations. An evaluation of the previous CCS was conducted and jointly discussed with the Ministry of Health as well as other key stakeholders. This process led to the identification of the, achievements, challenges and shortfalls of the previous CCS. Through this process the areas where WHO needed to focus on were also identified. The CCS development has also been done in parallel with the formulation of the new Health Sector Strategic Plan (HSSP) to ensure that there is a linkage between the two.
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The RTA covered UNICEF’s response to COVID-19 from March 2020 – when WHO declared the disease a pandemic – until January 2021. Further, the RTA applied a broad and cross-cutting lens to all 21 UNICEF county offices across the region, focusing on six case study
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countries: Kenya, Madagascar, Namibia, Somalia, South Africa and Uganda.
In addition to a Regional Analysis Report, the RTA produced six deep-dive reports with findings and lessons specific to the six case study countries mentioned above – all of which can be accessed through the drop-down listing on this page.
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The World Health Organization provides regional and national strategies and operational plans that aim to support countries in work to achieve measles control and elimination. These are guided by high level frameworks including the Immunization Agen
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da 2030 and the Measles and Rubella Strategic Framework 2021–2030. These frameworks promote improvements in routine immunization programmes to reach all children, reduce immunity gaps and prevent outbreaks within the context of universal health care.
This interim guidance on Targeted and selective strategies in measles and rubella vaccination campaigns adds to the suite of guidance documents. It provides expanded description of methods to determine age groups for inclusion in preventive and outbreak response measles and rubella vaccination campaigns; and operational considerations that are specific to targeted and selective strategies in measles and rubella vaccination campaigns. This guidance also updates definitions for tailored, targeted and selective campaigns.The World Health Organization provides regional and national strategies and operational plans that aim to support countries in work to achieve measles control and elimination. These are guided by high level frameworks including the Immunization Agenda 2030 and the Measles and Rubella Strategic Framework 2021–2030. These frameworks promote improvements in routine immunization programmes to reach all children, reduce immunity gaps and prevent outbreaks within the context of universal health care.
This interim guidance on Targeted and selective strategies in measles and rubella vaccination campaigns adds to the suite of guidance documents. It provides expanded description of methods to determine age groups for inclusion in preventive and outbreak response measles and rubella vaccination campaigns; and operational considerations that are specific to targeted and selective strategies in measles and rubella vaccination campaigns. This guidance also updates definitions for tailored, targeted and selective campaigns.
more
The humanitarian crisis in Northeast Nigeria, driven by conflict, climate-related shocks, and food insecurity, has created immense challenges for the health sector in Borno, Adamawa, and Yobe (BAY) States. About 1.8 million people remain displaced(1), with inadequate access to healthcare services an
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d persistent disease outbreaks, malnutrition, and mental health challenges. This strategy outlines a comprehensive localization approach to strengthen the health sector's capacity by empowering local and national actors (L/NAs) include state and local government structures to lead humanitarian responses at respective levels with minimal oversight functions.
The localization strategy aligns with the global commitments of the Grand Bargain 2.0, prioritizing equitable partnerships, capacity sharing, and resource mobilization to enhance sustainable, community-owned health systems(2). Key components include increasing the visibility and meaningful participation of L/NAs in health sector coordination, promoting direct funding to local actors, and addressing systemic barriers such as governance, leadership, capacity, and resource gaps.
The global humanitarian community made a commitment, as reflected in the Grand Bargain 2.0, to localization (3) to improve the efficiency and effectiveness of humanitarian aid. A key priority of this commitment is to empower local actors to take a leading role in delivering assistance, ultimately leading to better outcomes for affected communities. A localized health response, strengthened by partnerships, can achieve several key outcomes, including rapid response and access, community acceptance, cost-effectiveness, links to long-term development, and increased accountability to the community. Localization in health matters because it ensures sustainable and community-owned health responses.
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The second edition of the Women and Trachoma: Achieving Gender Equity in the Implementation of SAFE manual provides an updated resource for realistically increasing, improving, and supporting gender representation within trachoma elimination efforts
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at all levels. From the trachoma workforce to the patients, from trichiasis surgeons to schoolteachers, and from national to international managers and coordinators, the manual breaks down the various levels of trachoma elimination programming to highlight the areas where women and girls can have a greater impact in elimination effort
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The document titled "Manual for Stratifying Malaria Risk and the Elimination of Foci" by PAHO provides guidance for countries in the Americas on how to systematically assess and classify malaria transmission risk at subnational levels. It outlines a
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standardized approach to stratification and the identification of active transmission foci, helping public health authorities prioritize interventions, allocate resources efficiently, and implement targeted strategies to accelerate progress toward malaria elimination.
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Insufficient funding is hindering the achievement of malaria elimination targets in Africa, despite the pressing need for increased investment in malaria control. While Western donors attribute their inaction to financial constraints, the global health community has
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limited knowledge of China’s expanding role in malaria prevention. This knowledge gap arises from the fact that China does not consistently report its foreign development assistance activities to established aid transparency initiatives. Our work focuses on identifying Chinese-funded malaria control projects throughout Africa and linking them to official data on malaria prevalence. By doing so, we aim to shed light on China’s contributions to malaria control efforts, analysing their investments and assessing their impact. This would provide valuable insights into the development of effective financing mechanisms for future malaria control in Africa.
more
Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfunding, and recent reductions in official development
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assistance have been registered. To create fiscal
space for health, the pursuit of efficiency gains and exploring innovative health financing for health seem attractive. This paper sought to synthesize available evidence on the nature of innovative health financing instruments, mechanisms and policies implemented in Africa. We further reviewed the factors that hinder or facilitate implementation, the lessons learnt on the structure, the development process and the implementation.
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WHO recommends artemisinin-based combination therapies for treating uncomplicated malaria, alongside studies to monitor treatment effectiveness. Given the threat of antimalarial resistance, including partial resistance in several African countries,
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molecular tools are vital for tracking resistance. In 2015, WHO launched the External Quality Assessment scheme for nucleic acid amplification testing to ensure reliable lab results. Coordinated by WHO and operated by the United Kingdom National External Quality Assessment Service for Parasitology, the scheme provides quality-controlled specimens and reports to help improve testing accuracy. Experts recently discussed expanding the scheme to include antimalarial resistance markers.
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2023 was another year of significant progress in the fight against HIV, tuberculosis (TB) and malaria. In countries where the Global
Fund invests, there has been a full recovery from the disruptive impact of the COVID-19 pandemic. The results we h
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ave achieved in the last year build on our extraordinary track record of progress. Over the last two decades, our partnership has cut the combined death rate from AIDS, TB and malaria by 61%. As of the end of 2023, the Global Fund partnership has saved 65 million lives.
more
WHO, as the coordinating authority on international health, supports countries in protecting public health through evidence-based policies and actions. Considering the significant health burden and the multiple potential benefits of interventions, t
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he WHO Air Quality, Energy and Health Unit aims to support countries by providing evidence, building institutional capacity and leveraging the “health argument” to convene sectors to tackle air pollution and accelerate energy access.
more
The document provides a standardized protocol for evaluating the Early Warning Alert and Response Network (EWARN), a surveillance system used during humanitarian emergencies when regular national health surveillance may be disrupted. The purpose of EWARN is to detect outbreaks of communicable diseas
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es early and enable rapid public health response. The guidance explains how the system should be assessed in terms of its structure, implementation, effectiveness, and usefulness. It outlines the key steps of evaluation: preparation, system description, data collection, and post-evaluation reporting. The protocol highlights common challenges observed in previous EWARN implementations, such as delays in establishing the system, limited data quality, weak outbreak response, and lack of clear transition plans back to routine surveillance systems. It emphasizes the need to evaluate both weekly disease reporting and alert verification processes, and to review attributes such as simplicity, data quality, timeliness, sensitivity, and stability. The document also provides templates for interviews, data review forms, and laboratory assessment, as well as guidance on conducting remote evaluations when access is limited. The overall goal of the protocol is to ensure that EWARN functions effectively to detect and respond to outbreaks and that practical recommendations are developed to improve the system’s performance and sustainability in emergency settings.
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Operational Guidance. This operational guidance provides a structured approach to support countries in sustaining priority services for HIV, viral hepatitis and sexually transmitted infections in the context of reduced external funding. The guidance
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is intended for national governments, public health programmes, community-led organizations, civil society, technical partners and donors working to safeguard priority services, support phased adaptation, protect health outcomes and preserve hard-won gains.
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Operational requirements for implementing WHO recommendations in digital systems. 2nd edition.
To ensure that countries can effectively benefit from digital health investments, “digital adaptation kits” (DAKs) are designed to facilitate the acc
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urate reflection of WHO’s clinical, public health and data use guidelines in the digital systems that countries are adopting. DAKs are operational, software-neutral, standardized documentations that distil clinical, public health and data use guidance into a format that can be transparently incorporated into digital systems.
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This document aims to provide public health authorities in European Union and European Economic Area (EU/EEA) countries with guidance for improved preparedness planning taking the lessons that have been identified through various activities in the c
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ontext of recent public health crises (e.g. COVID-19 pandemic, mpox multi-country outbreak 2022–23) and translating them to concrete advice. This document, together with the ECDC recommendations on the implementation of public health and social measures (PHSMs) for health emergencies and pandemics published in 2024, form a package of concrete recommendations for preparedness planning for the EU/EEA countries. Lessons learned primarily from the response to the COVID-19 pandemic, but also from the response to the multicountry mpox outbreak in 2022–23, were collected through various activities from Member States, the European Commission, the World Health Organization (WHO) and the WHO Regional Office from Europe. We have then presented these in the form of specific recommendations for planners within each phase of the continuous cycle of preparedness (Anticipation, Response and Recovery), following a prototype structure of a preparedness and response plan. In each section, we have presented a relevant example from a Member State or international organisation to illustrate their practice or attempt to implement lessons after COVID-19 or the mpox outbreak. These examples were identified either through literature review or communication with representatives of the countries within ECDC’s network for Preparedness and Response.
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Guide to revision of national pandemic influenza preparedness plans - Lessons learned from the 2009 A(H1N1) pandemic
Brown C., Ciotti M., Hegermann-Lindencrone M., et al
European Centre for Disease Prevention and Control (ECDC), WHO Regional Office for Europe
(2017)
C_WHO
The document “Guide to revision of national pandemic influenza preparedness plans – Lessons learned from the 2009 A(H1N1) pandemic” provides guidance for countries on how to improve and update their national pandemic preparedness plans. It is
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based on lessons learned from the 2009 influenza pandemic and aims to help governments strengthen their readiness for future pandemics. The report outlines key components of effective pandemic planning, including risk assessment, coordination between sectors, communication strategies, healthcare system preparedness, vaccination and antiviral strategies, and business continuity planning. It also emphasizes the importance of international cooperation and flexible planning that can adapt to different pandemic scenarios. Overall, the guide serves as a framework to support countries in developing stronger, more coordinated responses to future influenza pandemics.
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