The information contained in this document, be it guidelines, recommendations, diagnostic algorithms or treatment regimens, are offered in this document in the public interest. To the best of the knowledge of the guideline writing team, the information contained in these guidelines is correct. Imple...mentation of any aspect of these guidelines remains the responsibility of the implementing agency in so far as public health liability resides, or the responsibility of the individual clinician in the case of diagnosis or treatment.
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This document updates the earlier version published in April 2020. In recent weeks, information on the potential use of chloroquine or hydroxychloroquine for the treatment of people with COVID-19 has been disseminated in academic journals and public media. Although there are now ongoing clinical tri...als testing the efficacy and safety of several medicines for COVID-19, as of the date of this document, there is a lack of quality evidence to demonstrate chloroquine and/or hydroxychloroquine are effective in the treatment of COVID-19. Evidence is recently emerging via small studies with sub-optimal methodologies that are conflicting.
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The portable diagnostic imaging technology covered by this document will serve not only the pressing demands for tuberculosis screening and triage but also other diseases. Therefore, the requirements, accessories, hardware and software packages listed in the following specifications are described in... detail in order to serve also other pathologies and conditions, like trauma and pneumonia.
Through the definition of "minimum technical requirements", this document is recommended to support decision-making regarding the selection, incorporation, allocation and use of portable X-ray systems and is intended for health care providers, managers of imaging departments, procurement and regulatory agencies, policymakers and planning officers in ministries of health, as well as biomedical engineering professionals, medical physicists, the private health sector, medical device industry and intergovernmental and international agencies.
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The meningitis road map has been designated as a flagship global strategy of the WHO’s Thirteenth General Programme of Work, 2019–2023 and is an essential component in achieving universal health coverage.
The road map will reinforce and combine with wider initiatives, such as those aimed at s...trengthening primary health care and health systems, increasing immunization coverage, improving global health security, fighting antimicrobial resistance and advocating for the rights of persons with disabilities. It will complement other global control strategies, such as those addressing sepsis, pneumonia, tuberculosis and HIV. Implementation will be a challenge for all countries across the world, but especially in resource-poor settings where the burden of meningitis is greatest. The targets for the visionary and strategic goals will be adapted to regional and local contexts.
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This is the first global report on epilepsy summarizing the available evidence on the burden of epilepsy and the public health response required at global, regional and national levels.
The reports highlights major gaps in awareness, diagnosis, treatment, and health policies through a series of a...ppalling numbers. With around 50 million people affected worldwide, epilepsy is one of the most common and serious brain disorders. Nearly 80% of people with epilepsy live in low-income and middle-income countries
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In 2019, the Global Fund’s 6th Replenishment raised more than $USD14 billion to fight HIV, Tuberculosis and Malaria. Just two years later, the world has changed significantly. Put simply: COVID-19 devastated prevention and treatment programs. For the first time since the Global Fund’s founding, ...in 2020 the world lost ground in the fight against HIV, Tuberculosis and Malaria.
The Global Fund moved quickly to support countries to respond to COVID-19 and its impact on the three diseases, repurposing and leveraging additional funding to support urgent needs and adapt programs. Despite those efforts, the need for action to resume progress in the fight against HIV, TB and malaria has never been greater.
The world faces a choice.
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The report focuses on antibacterial resistance (ABR) in common bacterial pathogens. There is a major gap in knowledge about the magnitude of this problem. Antimicrobial resistance (AMR) threatens the effective revention and treatment of an ever-increasing range of infections caused by bacteria, para...sites, viruses and fungi. This WHO report, produced in collaboration with Member States and other partners, provides for the first time, as accurate a picture as is presently possible of the magnitude of AMR and the current state of surveillance globally. It examines the information on AMR, in particular antibacterial resistance (ABR), at country level worldwide.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t...hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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Indicators for monitoring the 2016 United Nations Political Declaration on Ending AIDS
UNAIDS supports countries to collect information on their national HIV responses through the Global AIDS Monitoring (GAM) framework—an annual collection of 72 indicators on the response to HIV in a country.... These data form part of the data set used to report back to the General Assembly.
Different from the HIV epidemiological estimates that countries produce for data on the state of the epidemic in a country—that is, data for making estimates on the number of people living with HIV, AIDS-related deaths, etc.—GAM collects information on HIV programmes, including the number of people living with HIV who know their HIV status and people on HIV treatment, and on stigma and discrimination. A full list of the indicators is given in the GAM guidelines.
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his Framework begins with a desired future scenario and considers actions and interventions necessary to get there. It advocates for holistic view to address tuberculosis. The Framework revisits challenges and actions in four layers: TB specific; challenges in health systems that influence TB care; ...challenges in sectors beyond health that determine TB; and overarching governance issues. Multisectoral action and accountability are embedded in the Framework. The Framework is based on the principles of people-centered care and system development.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim...ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector development plans and the Health Sector Reform Strategy ...2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
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The Regional Action Framework for Noncommunicable Disease Prevention and Control provides a unified vision of objectives and recommended actions to combat the noncommunicable disease (NCD) epidemic in the Western Pacific Region. Implementation should be supported by cross-sectoral coordination..., sustainable financing, evidence-based policy, and community engagement, tailored to each Member State’s unique context. In doing so, Member States are encouraged to transform a disease treatment-centered “sick system” into a “health system” in which a population’s health and well-being enable socioeconomic development.
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Technical information note. Digital Adherence Technologies (DATs) such as the smart medication container
kit can help to support people affected by TB with their treatment in a modern
and ef-fective way. These technologies are able to deliver reminders and may
help em-power TB affected individual...s and their families to take their daily
medication at a time and place that suits them best. They also generate a
digital record of medication intake.
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9 June 2021
Since its launch, GLASS has expanded in scope and coverage and as of May 2021, 109 countries and territories worldwide have enrolled in GLASS. A key new component in GLASS is the inclusion of antimicrobial consumption (AMC) surveillance at the national level highlighted in this fourth G...LASS report.
The fourth GLASS report summarizes the 2019 data reported to WHO in 2020. It includes data on AMC surveillance from 15 countries and AMR data on 3 106 602 laboratory-confirmed infections reported by 24 803 surveillance sites in 70 countries, compared to the 507 923 infections and 729 surveillance sites reporting to the first data call in 2017.
The report also describes developments over the past years of GLASS and other AMR surveillance programmes led by WHO, including resistance to anti-human immunodeficiency virus and anti-tuberculosis medicines, antimalarial drug efficacy.
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Prevention, early diagnosis, and effective treatment are essential for the control and elimination of Neisseria gonorrhoeae as a public health problem. Currently, in Latin America and the Caribbean, treatment for gonorrhea infection is largely empiric and based on clinical diagnosis. In the Americas..., the high burden of new N. gonorrhoeae infections (estimated at 11 million new cases a year), the complexity of the disease epidemiology, and in many countries the limited resources, make it difficult to fully understand the burden of disease and the burden of antimicrobial resistance (AMR) in N. gonorrhoeae.
PAHO has developed this document to facilitate the navigation of available guidance and recommendations for N. gonorrhoeae AMR surveillance by public health and health care professionals, at the national and subnational levels, involved in designing, implementing, and/or strengthening AMR surveillance of N. gonorrhoeae and overall surveillance of sexually transmitted infections.
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This FY 2017 Malaria Operational Plan presents a detailed implementation plan for Senegal, based on the strategies of PMI and the National Malaria Control Program (NMCP) strategy. It was developed in consultation with the NMCP and with the participation of national and international partners involve...d in malaria prevention and control in the country. The activities that PMI is proposing to support fit in well with the new National Malaria Control strategy and plan (2016-2020) and build on investments made by PMI and other partners to improve and expand malaria-related services, including the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) malaria grants. This document briefly reviews the current status of malaria control policies and interventions in Senegal, describes progress to date, identifies challenges and unmet needs to achieving the targets of the NMCP and PMI, and provides a description of activities that are planned with FY 2017 funding.
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People Who Inject Drugs
In addition, the following individuals of our external expert advisory committee made instrumental contributions to the initial design and content of the document: Billy Pick, USAID; Daniel Wolfe, Open Society Foundations; Dave Burrows, AIDS Projects Management Group; Fabi...enne Hariga, United Nations Office on Drugs and Crime; Mauro Guarinieri, the Global Fund to Fight AIDS, Tuberculosis and Malaria; Richard Needle, Office of the U.S. Global AIDS Coordinator; and Sergey Votyagov, EHRN.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery ...of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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