A toolkit for pharmacists.
Emerging data show that medication errors and adverse events cause significant harm to patients’ health and
well-being. It is estimated that the burden of adverse events due to medicines is now comparable to that of
widespread diseases, such as malaria or tuberculosis....1 The impacts of medication errors also represent a
burden for health systems, with the annual cost associated with medication errors estimated at USD 42 billion
worldwideharm
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These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor treatment in people living with HIV; the treatment monitoring algorithm; and timing of antiretroviral therapy (ART) among people living w...ith HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
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This document is based on currently available scientific evidence on treatment for drug use disorders and sets out a framework for the implementation of the Standards, in line with principles of public health care. The Standards identify major components and features of effective systems for the tre...atment of drug use disorders. They describe treatment modalities and interventions to match the needs of people at different stages and severities of drug use disorders, in a manner consistent with the treatment of any chronic disease or health condition. The Standards are aspirational, and such, national or local treatment services or systems need not attempt to meet all the standards and recommendations made in this document all at once. However over time, progressive quality improvement, with ‘evidence-based and ethical practice’ as an objective, can and should be expected to achieve better organized, more effective and ethical systems and services for people with drug use disorders.
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There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.
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Putting Human Rights at the Heart of the Response
Topic in Focus: COVID-19 and Women’s Human Rights
15 April 2020
Stay-at-home restrictions and other measures restricting the movement of people contribute to an increase in genderbased violence, a finding confirmed by media reports, official ...statements and information received from OHCHR field presences and human rights defenders in many countries.
Women and girls already in abusive situations are more exposed to increased control and restrictions by their abusers, with little or no recourse to seek support. Hotlines receive reports of women being threatened with being thrown out of their homes, exposed to the infection, or having financial resources and medical aid withheld.
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Infectious disease outbreaks are periods of
great uncertainty. Events unfold, resources
and capacities that are often limited
are stretched yet further, and decisions
for a public health response must be
made quickly, even though the evidence
for decision-making may be scant. In
such a... situation, public health officials,
policy-makers, funders, researchers, field
epidemiologists, first responders, national
ethics boards, health-care workers, and public
health practitioners need a moral compass
to guide them in their decision-making.
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This report explores the access to healthcare granted to irregular migrants in 10 EU Member States. It focuses on migrants who are present in an irregular situation, namely those who do not fulfil conditions for entry, stay or residence. Through interviews with a range of different sources including... public authorities at the national and local level, health professionals, non-governmental organisations (NGOs) providing helathcare and irregular migrants themselves, this report documents the legal, economic and practical obstacles that hinder migrants' access to healthcare.
For versions in French, Polish, German and Swedish check also http://fra.europa.eu/de/publication/2012/migranten-einer-irregulren-situation-zugang-zu-medizinischer-versorgung-zehn
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This Technical Brief focuses on current principles and approaches to Moderate Acute Malnutrition (MAM) management, highlighting key constraints, gaps in knowledge and areas still lacking consensus. It is intended to inform ongoing debates among practitioners, national partners, donors and analysts o...n what information and evidence on best practices are currently available, where the gaps are, and priorities for going forward.
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Overcoming barriers in low- and middle-income countries
For the first time, this year’s report includes information on hepatitis C diagnostics. With a focus on selected countries with diverse HCV epidemics, the report provides updates on the various dimensions of access to HCV diagnostics and pha...rmaceutical products, including product pricing, the regulatory environment and patent status, which together shape the national hepatitis response in different settings. It highlights key areas for action by ministries of health and other government decision-makers, pharmaceutical manufacturers and technical partners.
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This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major cha...llenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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This version of Field Trials of Health Interventions includes seven new chapters on conducting systematic literature reviews, trial
governance, preliminary studies and pilot testing, budgeting and accounting, intervention costing and economic analysis, and Phase IV studies. Before new interventions... are released into disease control programmes, it is essential that they are carefully evaluated in ‘field trials’. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. This manual was designed to provide guidance on the practical issues in great detail
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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 us. 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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Modelling the health impacts of disruptions to essential health services during COVID-19 Module 1
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVI...D-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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This report presents an analysis of antibacterial agents in preclinical (third annual review) and clinical (fifth annual review) development. The analysis covers traditional (direct-acting small molecules) and non-traditional antibacterial agents in development worldwide. It evaluates to what extent... the present pipeline addresses infections caused by WHO Priority Pathogens, Mycobacterium tuberculosis and Clostridioides difficile. The report also provides an assessment of the traditional agents with respect to whether they meet a set of predefined criteria for innovation, namely absence of known cross-resistance, new target, mode of action and/or class. It also includes an overview of the agents that obtained authorization since 1 July 2017.
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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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This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment and care and mental health services for people living with HIV. It provides a compilation of tools, best practices, recommendations and guidelines that facilitate the integration of i...nterventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
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Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to severe illness, morbidity, and mortality, particularly in sub-Saharan Africa.
These guidelines update the recommendations that were first released i...n 2018 on diagnosing, preventing, and managing cryptococcal disease. In response to important new evidence that became available in 2021, these new guidelines strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This simplified regimen - a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) - is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
The objective of these guidelines is to provide updated, evidence-informed recommendations for treating adults, adolescents and children living with HIV who have cryptococcal disease. These guidelines are aimed at HIV programme managers, policymakers, national treatment advisory boards, implementing partners and health-care professionals providing care for people living with HIV in resource-limited settings with a high burden of cryptococcal disease.
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July 2021. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations and good practice statements within a public health, rights-based and person-centred approach.
These guidelines bring in... the most recent guidance on HIV testing strategies - the entry point for HIV prevention and treatment - and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
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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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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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