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In Control: A Practical Handbook for Professionals Working in Health Emergencies Internationally RKI
The greatest risk to persons engaging in international medical emergency response is poor preparation.
The In Control handbook hopes to provide a remedy.
At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health emergency that disregards physical borders, brin
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gs into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated.
Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all.
The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world.
The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards.
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Background: Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution of spending across diseases. We developed improved e
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stimates of health spending by source, including development assistance for health, and, for the first time, estimated HIV/AIDS spending on prevention and treatment and by source of funding, for 188 countries.
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CATALYST DIALOGUE ON HEALTH FINANCING
Insights from a debate on how to increase funding for health and spend existing funds more effectively.
Catalyst Dialogue participants:
Christoph Benn, Director for Global Health Diplomacy, Joep Lange Institute • Jayati Ghosh, Professor of Economics, Univer
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sity of Massachusetts at Amherst • Tom Hart, Research Fellow, ODI • Lesley-Anne Long, President & CEO, Global Business Coalition for Health • Riaz Tanoli, CEO, Social Health Protection Initiative, Health Department Khyber Pakhtunkhwa, Pakistan
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Securing a minimum of financial resources permitting to bring the full range of critical health services to all people constitutes a fundamental human right and an indispensable condition for human dignity. The model outlined here demonstrates that it is within our reach to close the financing gap e
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ven for the poorest countries by 2020 if all governments, from the privileged and underprivileged parts of the world alike, just fulfil the commitments and recommendations for financing human development and health that already were agreed many years ago.
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The importance of robust mortality surveillance systems cannot be overstated in an era marked by increasing global health challenges where health threats loom large and population dynamics continue to evolve. Accurate and timely mortality data is essential for identifying trends and detecting emergi
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ng health threats, evaluating the impact of interventions, and guiding evidence-based policy decisions.
This framework outlines a holistic approach to strengthening routine mortality surveillance systems, considering the unique contextual factors and challenges faced by African countries. It emphasizes the importance of establishing efficient data collection mechanisms, enhancing data quality and completeness, and promoting data sharing and collaboration among stakeholders.
Moreover, the framework recognizes the pivotal role of technology in the integration of data from fragmented mortality data sources. It highlights the potential of innovative data capture methods, advanced analytics, and real-time reporting systems to enhance mortality data’s accuracy, efficiency, and timeliness.
The continental framework for mortality surveillance aligns with Africa CDC’s mission and strategic goal by serving as a fundamental component in strengthening public health systems, enhancing disease surveillance capacities and capabilities, informing evidence-based policies and interventions, and promoting collaboration and coordination among African countries to address health challenges and improve health outcomes on the continent.
The successful implementation of this framework requires collective commitment and concerted efforts from governments, health institutions, and the international community. We hope this document will serve as a catalyst for transformative change, enabling countries to build resilient mortality surveillance systems that protect public health, save lives, and contribute to evidence-based decision-making.
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L'importance de systèmes de surveillance de la mortalité robustes ne peut être surestimée à une époque marquée par des défis sanitaires mondiaux croissants, où les menaces sanitaires pèsent lourd et la dynamique des populations continue d'évoluer. Des données précises et opportunes sur
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la mortalité sont essentielles pour identifier les tendances et détecter les menaces émergentes pour la santé, évaluer l'impact des interventions et orienter les décisions politiques fondées sur des données probantes.
Ce cadre décrit une approche holistique pour renforcer les systèmes de surveillance de routine de la mortalité, en tenant compte des facteurs contextuels uniques et des défis auxquels sont confrontés les pays africains. Il souligne l'importance d'établir des mécanismes de collecte de données efficaces, d'améliorer la qualité et l'exhaustivité des données et de promouvoir le partage des données et la collaboration entre les parties prenantes.
De plus, le cadre reconnaît le rôle central de la technologie dans l'intégration des données provenant de sources de données fragmentées sur la mortalité. Il met en évidence le potentiel des méthodes innovantes de capture de données, des analyses avancées et des systèmes de notification en temps réel pour améliorer la précision, l'efficacité et l'actualité des données sur la mortalité.
Le cadre continental de surveillance de la mortalité s'aligne sur la mission et l'objectif stratégique d'Africa CDC en servant d'élément fondamental dans le renforcement des systèmes de santé publique, l'amélioration des capacités et des capacités de surveillance des maladies, l'élaboration de politiques et d'interventions fondées sur des données probantes et la promotion de la collaboration et de la coordination entre les pays africains pour relever les défis sanitaires et améliorer les résultats sanitaires sur le continent.
La mise en œuvre réussie de ce cadre nécessite un engagement collectif et des efforts concertés de la part des gouvernements, des établissements de santé et de la communauté internationale. Nous espérons que ce document servira de catalyseur pour un changement transformateur, permettant aux pays de mettre en place des systèmes de surveillance de la mortalité résilients qui protègent la santé publique, sauvent des vies et contribuent à la prise de décision fondée sur des données probantes.
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The world has been turned on its head by the coronavirus disease 2019 (COVID-19) pandemic. This has provided a stark wakeup call on the severe under-financing of health systems around the world. It has laid bare the inequalities and limitations in the capacities of countries at all levels of develop
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ment to prevent major health crises or respond to them. But it doesn’t have to be this way.
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The 2021 Global monitoring report on financial protection in health shows that before the COVID-19 pandemic, the world was off-track to reduce financial hardship due to health expenditures because trends in catastrophic health spending were going in the wrong direction and the number of people incur
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ring impoverishing health spending remained unacceptably high (Chapter 1). Chapter 2 summarizes emerging evidence on the consequence of the pandemic and the related macroeconomic and fiscal crisis that points to the likely worsening of financial protection for households, particularly as a result of declining income and consumption, along with rising poverty and inequality
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Dieser Bericht enthält eine neue Strategie für Investitionen in die Gesundheit als Beitrag zur Wirtschaftsentwicklung, vor allem in den ärmsten Ländern der Welt, auf der Grundlage einer neuen globalen Partnerschaft zwischen sich entwickelnden und entwickelten Ländern. Zügiges und mutiges Hande
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ln könnte zum Ende dieser Dekade mindestens 8 Millionen
Menschenleben pro Jahr retten, die Lebensdauer und die Leistungsfähigkeit der Armen erhöhen und ihre wirtschaftliche Lage verbessern Hierfür wären zwei wichtige Initiativen zu ergreifen: eine deutliche Erhöhung der Mittel, die für Gesundheit ausgegeben werden,sowohl durch die armen Länder als auch durch die Geber und eine Beseitigung der nichtfinanziellen Hindernisse, die arme Länder in ihrer Fähigkeit zur Bereitstellung von Gesundheitsdiensten einschränken
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Past quantitative research on health financing has focused mostly on the level and distribution of total expenditure, with little emphasis on the specific role of public funds, despite their known importance for universal health coverage (UHC). Health Accounts data do not disaggregate public expendi
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ture on health by source of funding. Achieving a better understanding of public financing for health in the context of the macro-fiscal and health financing environment is of fundamental importance to the development of future health financing policy, particularly in low- and middle-income countries (LMICs).
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The present information document supplements the WHO audited financial statements for 2018. It contains information on WHO's voluntary contributions by fund and by contributor in the year 2018.
The Director-General has the honour to transmit to the Seventy-fifth World Health Assembly the report of the seventh meeting of the Working Group on Sustainable Financing, which met in a hybrid format, from 25 to 27 April 2022.
I examine the effectiveness of donors in targeting the highest burden of malaria in the Democratic Republic of Congo when health information structure is fragmented. I exploit local variations in the burden of malaria induced by mining activities as well as financial and epidemiological data from he
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alth facilities to estimate how local aid is matching local health needs. Using a regression discontinuity design, I find significant but quantitatively small variations in aid to health facilities located within mining areas. Comparing local aid with the additional cost of treatment and prevention associated with the increased risk of malaria transmission, I find suggestive evidence that local populations with the highest burden of the disease receive a proportionately lower share of aid compared to neighbouring areas with reduced exposure to malaria infection. The evidence of disparities in the allocation of aid for malaria supports the view that donors may have inaccurate information about local population needs.
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The development of this draft Proposed programme budget 2022–2023 comes at a unique moment for WHO. The world is in the grip of the coronavirus disease (COVID-19) pandemic and faces health, social and economic consequences on an unprecedented scale. Although it is not known when the COVID-19 pande
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mic will end, recent encouraging vaccine results, in addition to the examples of countries that have achieved good results through public health measures, hold out the prospect of better days ahead. The full impact of the pandemic cannot yet be determined. But whatever its implications, the Secretariat will rise to the challenge and is ready to adapt so that it is fully equipped to support Member States for any eventuality in the future – to make sure that the world will never again have to face this kind of crisis.
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Background: In 2015, 5.3 million babies died in the third trimester of pregnancy and first month following birth. Progress in reducing neonatal mortality and stillbirth rates has lagged behind the substantial progress in reducing postneonatal and maternal mortality rates. The benefits to prenatal an
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d neonatal health (PNH) from maternal and child health investments cannot be assumed. Methods: We analysed donor funding for PNH over the period 2003–2013. We used an exhaustive key term search followed by manual review and classification to identify official development assistance and private grant (ODA+) disbursement records in the Countdown to 2015 ODA+ Database.
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Oral health is defined as the absence of disease and a status that ensures optimal functioning of the mouth and its tissues in a manner preserving the highest level of function and self-esteem. Oral health enables an individual to eat, speak and socialise having no active disease, discomfort or disc
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ouragement thus contributing to the general well-being. Good oral health is an essential component of general health and a right of every person1. Poor oral health has a negative impact on general health, work productivity, educational performance and adversely affects growth and development.
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Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequency. In addition to resulting in high mortality and morbidity, the outbreaks generate fear and mistrust about the response activities within the communities affected.
Infection prevention and control (IP
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C) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
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It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t
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he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency.
Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls.
An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is:
A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes).
An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa.
The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions.
Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward.
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The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline
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is available both online and PDF.
**This version of the living guideline (version 5.0) **includes the following seven revised statements for the prevention, identification and management of SARS-CoV-2 infections among health and care workers:
a good practice statement on national and subnational testing strategies;
a good practice statement on passive syndromic surveillance of health and care workers;
a good practice statement on prioritizing health and care workers for SARS-CoV-2 testing;
a good practice statement on protocols for reporting and managing health and care worker exposures;
a good practice statement to limit in-person work of health and care workers with active SARS-CoV-2 infections;
a statement on high-risk exposures and quarantine; and,
a conditional recommendation on the duration of isolation for health and care workers.
Understanding the updated section
Prevention of infections in the health care setting includes a multi-pronged and multi-factorial approach that includes IPC and occupational health and safety measures and adherence to Public Health and Social Measures in the community by the health workforce. The underlying infection prevention and control strategy of this section is the notion that early identification of symptomatic cases, testing and quarantining/isolating health and care workers decreases the risk of nosocomial infection to patients and to other health and care workers.
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Member States of the Region have initiated processes to strengthen leadership and governance for mental health. Several countries have developed and implemented mental health plans, strategies and legislations. Direct spending on mental health needs to be increased throughout the Region through the
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health sector as well as other relevant sectors.
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