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This publication is part of WHO 75th anniversary and aims to capture key successes in public health globally and in Namibia. It includes contributory messages from the Head of State, Prime Minister and the Minister of Health and Social Services.
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
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, 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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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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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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There is growing understanding and high-level endorsement of the importance of strong collaborative multisectoral approaches to address a broad range of social, economic and governance issues for the prevention and control of noncommunicable disease (NCDs) and mental health conditions. In 2019, Worl
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d Health Organization (WHO) Member States requested the WHO Director-General to provide an analysis across countries of successful approaches for the prevention and control of NCDs that used multisectoral action. This WebAnnex to the Global mapping report on multisectoral actions to strengthen the prevention and control of noncommunicable diseases and mental health conditions details experiences from around the world.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
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3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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The Disaster Recovery Framework (DRF) Guide for the Health Sector provides guidance on how to implement a comprehensive, integrated, and structured approach to disaster recovery. Its overarching goal is to minimize the impact of the disaster on communities and help countries to recover quickly and e
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ffectively from disasters, in coordination with key stakeholders.
The DRF Guide for the Health Sector is adapted from the generic DRF Guide, and draws on the Implementation Guide For Health Systems Recovery in Emergencies, the Health Emergency and Disaster Risk Management Framework as well as the Disaster Recovery Guidance Series. The guide also makes links with multi-sectoral, government-led recovery planning processes such as the Post-Disaster Needs Assessment (PDNA), and it supports the implementation of the HDPN.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the
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patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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Document provides basic information on Hypertension (symptoms, risk factors, complications, treatment) in a descriptive way.
The document provides information on stroke (definition, risk factors, symptoms etc.) in a descriptive way.
Cardiovascular disease, heart disease, and coronary heart disease may sound similar but they are not one in the same. This fact sheet will help you understand how these conditions differ.
Interested in leading a more heart healthy lifestyle? Small steps go a long way especially when you connect with others to stay motivated. This fact sheet suggests several lifestyle changes you can make starting today and ways to get your friends, family, and colleagues involved.
Heart failure (HF) is a global public health concern with disproportionate socioeconomic, morbidity and mortality burden on low- and middle-income countries (LMICs). This review summarises contemporary data on the demographic and clinical characteristics, aetiologies, treatment, economic burden and
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outcomes of HF in LMICs. Patients with HF in LMICs are younger than those from high-income countries (HICs) and present at advanced stages of the disease. Hypertension, ischaemic heart disease (IHD), cardiomyopathy (CMO), and rheumatic heart disease (RHD) are the leading causes of HF in LMICs. The contribution of infectious diseases to HF remains prominent in many LMICs. Most health facilities in LMICs lack adequate diagnostic tools for HF, and the use of evidence-based medical and device therapies is suboptimal. Further, HF in LMICs is associated with prolonged hospital stay and high in-hospital and one-year mortality. Finally, HF has profound economic impact on individual patients who, mostly, have no health insurance, and on societies where patients are young, comprising those who have the greatest potential to contribute to economic productivity.
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These key factors can help you live a longer, healthier life and reduce your risk of heart disease and stroke. They’re part of an overall healthy lifestyle and prevention approach you can build with your health care team (doctors, nurses, pharmacists and other professionals).
This guide for patients aims to provide you with an overview of the latest evidence-based recommendations for the prevention of cardiovascular disease. In particular, it should help you to understand:
• how cardiovascular disease risk is assessed
• the importance of lifestyle modifications for
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prevention of cardiovascular disease
• treatments and treatment goals that may be considered appropriate based on
your risk profile
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Prevention of stroke and transient ischemic attack includes both conventional approaches to vascular risk factor management (blood pressure lowering, cholesterol reduction with statins, smoking cessation and antiplatelet therapy)
and more specific interventions, such as carotid revascularization or
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anticoagulation for atrial fibrillation. The objective of this review is to discuss effective interventions for optimal primary and secondary stroke prevention.
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This paper explores the angles and opportunities of digital health, with a look
at digital innovation and its potential to support patients with circulatory diseases.
In reviewing developments in the field, current applications as well as gaps, the paper aims to support policymakers in leveraging
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technology for better circulatory health and to capture the roles that various sectors have in making
digital health a tool for everyone.
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The Mexico Declaration for Circulatory Health brings together global health
organizations committed to improving circulatory health and reducing deaths and disability from heart disease and stroke around the world. These diseases presently represent the biggest health burden world-wide, accounting
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for over 17 million deaths every year. We are united around existing global strategies and targets to reduce the burden of heart disease and stroke. We are committed to achieving the World Health Organization (WHO) “25 by 25” non-communicable disease (NCD) targets, and the United Nations’ NCDrelated Sustainable Development Goals, based on known, effective and affordable
interventions for secondary prevention, primary prevention and primordial prevention in populations. As heart disease and stroke make up half of all NCD deaths, our efforts, working together as the international cardiovascular community, are central to achieving these global goals.
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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
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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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Background
Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-
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incidence ratio (MIR) across the world over 28 years.
Methods
The age-standardized CVD mortality and incidence rates were retrieved from the Global Burden of Disease (GBD) Study 2017 for both genders and different world super regions with available data every year during the period 1990–2017. Additionally, the Human Development Index was sourced from the United Nations Development Programme (UNDP) database for all countries at the same time interval. The marginal modeling approach was implemented to evaluate the mean trend of CVD incidence, mortality, and MIR for 195 countries and separately for developing and developed countries and also clarify the relationship between the indices and Human Development Index (HDI) from 1990 to 2017.
Results
The obtained estimates identified that the global mean trend of CVD incidence had an ascending trend until 1996 followed by a descending trend after this year. Nearly all of the countries experienced a significant declining mortality trend from 1990 to 2017. Likewise, the global mean MIR rate had a significant trivial decrement trend with a gentle slope of 0.004 over the time interval. As such, the reduction in incidence and mortality rates for developed countries was significantly faster than developing counterparts in the period 1990–2017 (p < 0.05). Nevertheless, the developing nations had a more rather shallow decrease in MIR compared to developed ones.
Conclusions
Generally, the findings of this study revealed that there was an overall downward trend in CVD incidence and mortality rates, while the survival rate of CVD patients was rather stable. These results send a satisfactory message that global effort for controlling the CVD burden was quite successful. Nonetheless, there is an urgent need for more efforts to improve the survival rate of patients and lower the burden of this disease in some areas with an increasing trend of either incidence or mortality.
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