Asthma prevalence is increasing worldwide and surveys indicate that the majority of patients in developed and developing countries do not receive optimal care and are therefore not well controlled. The aim of these guidelines is to promote a better standard of treatment based on advances in the unde...rstanding of the pathophysiology and pharmacotherapy of asthma and to encourage uniformity in the management of asthma.
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The European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force on severe asthma includes an updated definition of severe asthma, a discussion of severe asthma phenotypes in relation to genetics, natural history, pathobiology and physiology, as well as sections on evaluation and tr...eatment of severe asthma where specific recommendations for practice are made. See the unabridged online version of the document for detailed discussion of the definition of severe asthma, phenotypes and recommendations for practice.
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The Sustainable Development Goals (SDGs) call for major societal transformations that will require significant fiscal outlays as well as private investments. The fiscal outlays cover public investments, the public provision of social services, and social protection for vulnerable populations. The ke...y message of this paper, building on recent reports by the IMF and SDSN (IMF, 2019b; SDSN, 2018) is that the governments of Low-Income Developing Countries (LIDCs) will require a substantial increase in fiscal (budget) revenues, far beyond what they can achieve by their own fiscal reforms. For this reason, SDG financing will require substantial international cooperation to enable the LIDCs to finance their SDG fiscal outlays. One important source of increased revenues should be the globally coordinated taxation of ultra-high-net worth assets. Today’s ultra-rich should help to pay for the survival and basic needs of the world’s poorest people.
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The purpose of this workbook is to assist ministries of health, health managers and practitioners in engaging with the private sector on delivery of quality maternal, newborn and child health (MNCH) services in lower- and middle-income countries. Private health care is one of the fastest growing seg...ments of the health-care system in lower- and middle-income countries, and private providers are an important source of health care. To accelerate progress to reach the Sustainable Development Goals for ending preventable maternal, newborn and child deaths, it is critical that whole health system organizations invest not only in increasing coverage of interventions, but also in quality. The audience for the workbook is those who are involved with organizing and implementing processes for engaging the private sector in delivery of quality MNCH services.
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The COVID-19 pandemic has resulted in a double shock - health and economic. As of March 1, 2021, COVID-19 has cost more than 2.5 million lives and triggered an economic recession surpassing any economic downturn since World War II.
Part I of this paper explores the impact of this current macro-fisc...al outlook on the three primary sources of health spending. Drawing on experiences from previous economic crises, scenario analyses suggest a fall in government per capita spending on health in 2021 and 2022 unless governments make bold choices to increase the share of health in general government spending.
Part II of the paper discusses policy options to meet the spending needs in health. These options encompass strategies to make fiscal adjustments work and channel funds where they are most needed, as well as policies to stabilize the balance sheets of social health insurance (SHI) schemes. The paper explains how the health sector can play an active role in expanding fiscal space, contributing to tax reforms, most importantly pro-health taxes, and mobilizing and absorbing external financing, including debt relief.
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The 2021 Financing for Sustainable Development Report responds to the request made by Member States to review the impact of the COVID-19 pandemic on nancing for sustainable development, and to propose recommendations to rebuild better. The report underlines the need for policy actions to ensure e e...ctive support until the recovery is rmly underway. Its thematic chapter discusses the systemic and interlinked nature of risk in a tightly intertwined world, and the importance of providing nancing for risk reduction and resilience and nancing that is risk-informed and resilient. With the collaboration of more than 60 agencies of the United Nations system and partner international organizations, the report provides much needed guidance to Member States to take action towards a more resilient future.
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The 2022 Financing for Sustainable Development Report identifies a “great finance divide” as a main driver of the divergent recovery. Developed countries were able to borrow record sums at ultra-low interest rates to support their people and economies, but the pandemic response and investment in... recovery of poor countries was limited by fiscal constraints. This joint report, by over 60 agencies of the United Nations system and partner international organizations, provides analysis and puts forward policy recommendations to overcome this “finance divide” and enhance developing countries’ access to financing for recovery and productive and sustainable investment.
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Non-communicable diseases (NCDs) are of increasing concern for society and national governments, as well as globally due to their high mortality rate. The main risk factors of NCDs can be classified into the categories of self-management, genetic factors, environmental factors, factors of medical co...nditions, and socio-demographic factors.
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A major problem facing the world is how to build peace following the ravages of increasingly protracted armed conflict. Armed conflicts leave behind shattered, divided societies that are at risk of repeating cycles of violence, and therefore need concerted peacebuilding efforts. Conflicts also take ...a heavy toll on people’s mental health and psychosocial well-being. One in five people who live in a war zone will likely develop a mental disorder, and many others suffer from painful everyday stresses associated with multiple losses, family separation, gender-based violence (GBV), disability, climate change and ongoing insecurity, among other issues.
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Multiple pandemics, numerous outbreaks, thousands of lives lost and billions of dollars of national income wiped out—all since the turn of this century, in barely 17 years—and yet the world’s investments in pandemic preparedness and response remain woefully inadequate. We know by now that the ...world will see another pandemic in the not-too-distant future; that random mutations occur often enough in microbes that help them survive and adapt; that new pathogens will inevitably find a way to break through our defenses; and that there is the increased potential for intentional or accidental release of a synthesized agent. Every expert commentary and every analysis in recent years tells us that the costs of inaction are immense. And yet, as
the havoc caused by the last outbreak turns into a fading memory, we become complacent and relegate the case for investing in preparedness on a back burner, only to bring it to the forefront when the next outbreak occurs. The result is that the world remains scarily vulnerable.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety and quality of care. Such services are also essential for creating an environment that supports the dig...nity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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The Water and Sanitation for Health Facility Improvement Tool (WASH FIT) presents a framework and acts as a guide to support multisectoral action to improve water, sanitation and hygiene (WASH) in health care. Central to the WASH FIT methodology is training and incremental improvements.
Implementat...ion of WASH FIT requires six preparatory steps at the national level, one of which is conducting national sensitization and training of trainers, followed by facility-level training. At the facility level, step 1 (of five) involves establishing and training a WASH FIT team.
The WASH FIT methodology is outlined in WASH FIT: A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities. Second edition. (the WASH FIT guide), which includes a set of templates designed to help users with each phase of the improvement cycle.
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The Advancing Climate-Resilient Education Technical Guidance builds on the USAID 2022–2030 Climate Strategy and the 2018 USAID Education Policy to support USAID Missions and partners who seek to integrate climate action and awareness into education programs and are committed to achieving climate-r...esilient education systems and fostering climate-resilient learners. It outlines how to identify opportunities for climate action that respond to known climate hazards through mitigative, adaptive, and transformative actions.
The guidance is designed for use at the activity design and monitoring and evaluation stages of the USAID Program Cycle. It does not prescribe new processes, but rather serves to aid Missions and partners in integrating climate considerations into existing processes
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This Urban Flood Risk Handbook: Assessing Risk and Identifying Interventions is a roadmap for conducting an urban flood risk assessment in any city in the world. It includes practical guidance for a flood risk assessment project, covering the key hazard and risk modeling stages as well as the evalua...tion of different flood-mitigating infrastructure intervention options and management of the project. The Handbook has been developed based on lessons learned from implementing urban flood risk assessments around the world in a diversity of contexts. It is intended for a wide variety of practitioners: project managers, city officials, and anyone else interested in conducting a strategic study of a city's flood risk and developing potential solutions for it. We expect this Handbook tocontribute to the understanding of urban flood risk, make this specialized knowledge more accessible to a wider public, and support the process of building cities that are not only capable of withstanding floods but also provide safe, inclusive, and sustainable environments for all their residents.
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The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20...30, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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In sum, the goal is to understand the need to increase fiscal space for health as a prerequisite, but within the framework of efforts to transform the health system. These changes should foster equitable and efficient expenditures and create or strengthen comprehensive integrated health systems with... a first level of care capable of solving health problems and coordinating networks, based on a primary health care approach that offers not only curative care but also health promotion and disease prevention services.
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Following the publication of Guidelines on certification of elimination of human onchocerciasis in 2001 by the World Health Organization (WHO), these are the first evidence-based guidelines developed by NTD Department according to the international standards. They provide a set of recommendations th...at would guide national programme managers in collaboration with their respective oversight committees on when to stop mass drug administration (MDA) and conduct post-treatment surveillance (PTS) activities for a minimum period of 3 to 5 year before confirming the interruption of transmission of Onchocerca volvulus parasite and hence its elimination. They also include steps to undertake for verification of elimination of transmission of the parasite in the whole endemic country by the International Verification Team (IVT) prior to the official acknowledgement by WHO Director General.
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Driving progress towards rabies elimination: Results of Gavi’s Learning Agenda on rabies and new WHO position on rabies immunization
Chagas disease is currently endemic and also predicted to be at increased transmission risk under future climate change scenarios. Similarly, an expansion of areas in the United States at increased risk for Chagas disease transmission is also expected over the next several decades under climate chan...ge scenarios. Of particular interest is the predicted northern shift of triatomine species to central regions of the United States with historically unsuitable climates for T. cruzi vectors. The weight of evidence regarding the influences climate change may pose on T. cruzi vector species distributions demonstrates the sensitivity of Chagas disease transmission to future climate variability. In order to advance forecasts for the impact climate change may have on Chagas disease transmission in the Americas, it is imperative to
further develop, utilize, and perhaps combine predictive species distribution modeling approaches that integrate accurate, long term data on climate variables, vector species distributions, Chagas disease incidence, as well as other socio-ecological variables.
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