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PNAS 119 (8) e2113947119 | https://doi.org/10.1073/pnas.2113947119
Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs
...
in rivers, these employ different analytical methods, measure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.
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In 2014, an estimated 40 million women of reproductive age were infected with Schistosoma haematobium, S. japonicum and/or S. mansoni. In both 2003 and 2006, the World
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Health Organization (WHO) recommended that all schistosome-infected pregnant and breastfeeding women be offered treatment, with praziquantel, either individually or during treatment campaigns. In 2006, WHO also stated the need for randomized controlled trials to assess the safety and efficacy of such treatment. Some countries have yet to follow the recommendation on treatment and many programme managers and pregnant women in other countries remain reluctant to follow the recommended approach.
more
Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable
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morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 2021 to 784 million by 2045.1 As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030.2 Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
more
Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable
...
morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 2021 to 784 million by 2045. As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030. Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
more
Clinical Microbiology and Infection Volume 21, Issue 5, May 2015, Pages 433-443;
The neglected zoonotic diseases (NZDs) have been all but eradicated in wealthier countries, but remain major causes
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of ill-health and mortality across Africa, Asia, and Latin America. This neglect is, in part, a consequence of under-reporting, resulting in an underestimation of their global burden that downgrades their relevance to policy-makers and funding agencies. Increasing awareness about the causes of NZDs and how they can be prevented could reduce the incidence of many endemic zoonoses.
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Antimicrobial resistance (AMR) as a serious public health threat was globally acknowledged by WHO in 2015, through the launch of the Global Action Plan (GAP). With a limited number of new antibiotic
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s in the developmental pipeline, many countries are in the process of establishing strategies for antimicrobial stewardship (AMS). Within each country, different healthcare challenges have
contributed to AMR. This has also shaped individual AMS strategies and policies. In South Africa (SA), there is a high burden of infectious diseases, mainly of bacterial origin. In addition, SA also has the highest number of people living with
human immunodeficiency virus (HIV) globally. According to the 2019 statistics, there are approximately 7.97 million people living with HIV in SA. Together with this, SA has the fourth largest tuberculosis population globally.
Other important challenges include poverty, malnutrition, a high burden of non-communicable diseases, and a dire shortage of trained healthcare professionals (e.g. clinicians, pharmacists, and nurses).
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Human rights must be at the centre of all prevention, preparedness, containment and treatment efforts from the start, in order to best protect public heal
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th and support the groups and people who are most at risk. States have an obligation to protect and guarantee everyone the right to the highest attainable standard of health.
All European states have committed to fulfilling the right to health and have signed international and regional human rights treaties to that purpose. In the context of the current pandemic, authorities should engage all available resources to counter the pandemic while fulfilling the right to health.
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This document lays out economic arguments for investing in the Access to COVID-19 Tools Accelerator (ACT-Accelerator). Framed within an overall context that recognizes the broader human health and s
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ocietal impacts of the COVID-19 crisis, ACT-Accelerator's Economic Investment Case argues that investment in ACT-Accelerator is the world’s best bet and most viable solution for restarting the global economy. It is intended for governments, multilaterals, civil society, businesses and foundations and all those interested in the work required to change the course of the pandemic. The global deployment of ACT-Accelerator’s comprehensive package of tools will reduce the severity of COVID-19 disease, enabling countries to transition out of the crisis thereby restarting domestic and international economic engines driving our global economy.
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Lessons learned around RCCE in outbreak responses in East and Southern Africa recognise the need to learn from and strengthen national and cross-border collaboration
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in the face of frequent public health emergencies. In October 2023, One Health partners conducted a Simulation Exercise in the Mandera region between Ethiopia, Kenya, and Somalia to test cross-border readiness. One of the key recommendations from this workshop was that current and future agreements, plans, and SOPs on One Health Emergency Preparedness and Response (EPR) in all three countries should include RCCE for cross-border situations.
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Integrating Clinical Research into Epidemic Response: The Ebola Experience
Gerald Keusch, Keith McAdam, Patricia Cuff, Michelle Mancher, and Emily R. Busta
National Academies of Sciences, Engineering, and Medicine
(2017)
C1
The 2014–2015 Ebola epidemic in western Africa was the longest and most deadly Ebola epidemic in history, resulting in 28,616 cases and 11,310 de
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aths in Guinea, Liberia, and Sierra Leone. The Ebola virus has been known since 1976, when two separate outbreaks were identified in the Democratic Republic of Congo (then Zaire) and South Sudan (then Sudan). However, because all Ebola outbreaks prior to that in West Africa in 2014–2015 were relatively isolated and of short duration, little was known about how to best manage patients to improve survival, and there were no approved therapeutics or vaccines. When the World Heath Organization declared the 2014-2015 epidemic a public health emergency of international concern in August 2014, several teams began conducting formal clinical trials in the Ebola affected countries during the outbreak.
more
According to the Report, cascading and interlinked crises are putting the 2030 Agenda for Sustainable Development in grave danger, along with humanity’s very own survival. The Report highlights the severity and magnitude of the challenges before u
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s. The confluence of crises, dominated by COVID-19, climate change, and conflicts, are creating spin-off impacts on food and nutrition, health, education, the environment, and peace and security, and affecting all the Sustainable Development Goals (SDGs). The Report details the reversal of years of progress in eradicating poverty and hunger, improving health and education, providing basic services, and much more. It also points out areas that need urgent action in order to rescue the SDGs and deliver meaningful progress for people and the planet by 2030.
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Future of Nursing 2020-2030
Wakefield, M.K.; et al.
National Academy of Medicine; National Academies of Sciences, Engineering, and Medicine
(2021)
C1
Charting a Path to Achieve Health Equity. The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of
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health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions.
Free download available, register for free
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Antimicrobial resistance has become one of the most eminent threats to global health and a rising concern for healthcare specialists. All around the world, many common infections are becoming resist
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ant to the antimicrobial medicines used to treat them, resulting in high morbidity and mortality with serious social and economic implications. Additionally, there are few new antibiotics being developed but they are expensive and are not new classes. Antimicrobials are critical in the management of infectious diseases. They are also essential tools for protecting animal health and welfare, and contribute in production of safe food. Inappropriate use of antimicrobials can lead to resistance which is known as the antimicrobial resistance (AMR) resulting in high morbidity and mortality with serious social and economic implications.
more
As the COVID-19 pandemic continues to threaten health and food systems around the world, the 2020 Global Nutrition Report calls on governments, businesses and civil society to step up efforts to address malnutrition
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in all its forms.
more
The Infection Prevention and Control (IPC) Legal Framework comes before the Specialized Technical Committee on Health and Drug Control for adoption and endorsement. The IPC Legal Framework is designed to guide Member States
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in the review and strengthening of laws and policies that support IPC at both the national level and in healthcare facilities. In developing this IPC Legal Framework, the Africa Centres for Disease Control and Prevention (Africa CDC)
is furthering its mandates to harmonize disease control and prevention policies and promote the prevention and control of diseases by building capacity of public health institutions in Members States.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc
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e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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Accessed on 10.03.2021
This law guidebook is a simplified summary of Kenyan disability policy, so that those who have disabilities or are associated with them can be aware of their rights. This guidebook is meant to be an introduction and a simple guide to Kenyan laws that concern people with disa
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bilities. It must be noted that this guidebook is not comprehensive. If the reader wants to know more about a specific law, she or she should look it up. All of the laws and policies have been cited so the reader can find them in the respective legal documents.
more
Maternal, Infant and Young Child Nutrition Strategic Actions:
1 Endorse and disseminate key policies and regulations
2 Improve maternal nutrition
3 Protect, promote, and support optimal infant and young child feeding practices
4 ... Support optimal infant and young child feeding in difficult circumstances
5 Ensure intra-sectoral integration (Health and Nutrition)
6 Improve intersectoral integration (food security and livelihood, WASH, protection, education and shelter)
7 Support capacity building and service strengthening
8 Initiate advocacy and social behavioural change communication
9 Sustain research, information, monitoring and evaluation
10 Mobilise resources and support more
1 Endorse and disseminate key policies and regulations
2 Improve maternal nutrition
3 Protect, promote, and support optimal infant and young child feeding practices
4 ... Support optimal infant and young child feeding in difficult circumstances
5 Ensure intra-sectoral integration (Health and Nutrition)
6 Improve intersectoral integration (food security and livelihood, WASH, protection, education and shelter)
7 Support capacity building and service strengthening
8 Initiate advocacy and social behavioural change communication
9 Sustain research, information, monitoring and evaluation
10 Mobilise resources and support more
The handbook on supply chain management for HIV/AIDS commodities was written to assist program managers to plan and implement day–to-day management of all drugs and medical supplies for an HIV/AIDS program. Many of the suggest
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ed techniques described in this handbook are helpful to program managers starting to plan or scale-up provision of drugs and supplies for a HIV/AIDS program. Additionally, some of the information may be helpful to readers who are implementing a new program and may not have robust logistics systems in place. For other readers, this handbook may serve as a checklist of systems and procedures that need to be in place in order to manage the many of the health commodities required for the HIV/AIDS program.
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