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, m...easure 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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Candid Conversations is a podcast where we talk to family planning and reproductive health champions from around the globe and take a deep dive into current topics in family planning and reproductive health, as well as the personal journeys of our champions, the challenges they’ve faced, what exci...tes them about the future and some advice for other up and coming leaders.
Our Goals:
Highlight the new generation of family planning leaders and the trailblazing work they are doing
Discuss the challenges youth face starting new programs and managing existing projects
Give a youth perspective on the needs of youth and the changing reproductive health landscape
Below are our latest episodes. Tune in by clicking below, listening to us on Apple podcasts, subscribing to our Youtube channel, or following us on Spotify.
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Young people living in the Central African Republic, Chad, Nigeria, Guinea, and Guinea-Bissau are the most at risk of the impacts of climate change, threatening their health, education, and protection, and exposing them to deadly diseases. The report is the first comprehensive analysis of climate ri...sk from a child’s perspective. It ranks countries based on children’s exposure to climate and environmental shocks, such as cyclones and heatwaves, as well as their vulnerability to those shocks, based on their access to essential services.
Additional translations of the Executive Summary are available in the following languages, with thanks to Climate Cardinals: English, French, Arabic, Hausa, Portuguese, Spanish, Somali, Yoruba
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Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that of the general population. To achieve tuberculosis control in these communities, it is necessary to respond t...o communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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Accessed: 27.04.2020
Leaving no one behind in the Covid-19 Pandemic: a call for urgent global action to include migrants & refugees in the Covid-19 response
People on the move, whether they are economic migrants or forcibly displaced persons such asylum seekers, refugees, and internally displa...ced persons (hereafter called migrants & refugees), should be explicitly included in the responses to the coronavirus disease 2019 pandemic. This global public health emergency brings into focus, and may exacerbate, the barriers to healthcare these populations face. Many migrant & refugee populations live in conditions where physical distancing and recommended hygiene measures are particularly challenging. The Covid-19 pandemic reveals the extent of marginalisation migrant & refugee populations face. From an enlightened self-interest perspective, the Covid-19 disease outbreak control measures will only be successful if all populations are included in the response. It is counter- productive to exclude migrant & refugee populations from the preparedness and response to the Covid-19 pandemic.
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The Facilitator's Guide has been piloted in Borno (Nigeria) and in Fafan zone (Somali region, Ethiopia) and improved iteratively after each test.
What does the ROAP have that you won't find in other methodologies?
It is based on holistic, people-centred approaches that span across sectors an...d consider people's perceptions, priorities, ways of coping, and assistance preferences.
It introduces the concepts of inter-sector needs profile and inter-sector causal analysis, and how to use these to articulate shared objectives and better integrated and holistic response packages, as opposed to siloed plans.
It introduces the concept of basic needs basket, and how to define the BN basket based on both households' perspective and sector experts' opinions, and acknowledging that needs have different frequencies and timings, and units of analysis (individual, household, community).
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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro...bial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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This course will equip clinicians who frequently prescribe antimicrobials with knowledge and tools to improve their use of these essential medications in daily clinical practice. Through case based examples, the course will highlight how antimicrobial stewardship principles can be applied to common ...clinical scenarios. We will first review foundational clinical knowledge necessary to use antimicrobials wisely. Then, we will illustrate how clinicians can incorporate this knowledge into the management of patients with common infections through adherence to the five core competencies of appropriate antimicrobial prescribing. This course will provide a framework for approaching each clinical encounter from the perspective of combating antimicrobial resistance.
The course is available in English, French, Italian, Russiand and Spanish
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Climate change, increasing population densities, and intensified globalisation in trade, travel and migration are among the most important factors shaping the 21st century. Each impacts upon population health and the risk of infectious disease, particularly those originating at the human-animal-envi...ronmental interface. The recognition that many risk drivers of infectious disease fall outside of the typical domain of the health sector creates the challenge of identifying and pursuing priorities for cross-sectoral action aimed at strengthening global health security. In response, the One Health concept has emerged, as have related initiatives addressing Planetary Health and Biodiversity and Human Health. From a public health perspective and operationally speaking, the One Health approach offers great potential, emphasising as it does cooperation and coordination between multiple sectors. Yet despite having been a focal point for discussion for over a decade, numerous challenges facing the implementation of One Health preparedness strategies remain. While some are technical, related to the requirement for innovative early warning systems or new vaccines, for example, others are institutional and cultural in nature, given the transdisciplinary nature of the topic. There have thus been calls to address One Health from multiple perspectives, from ecology to the social sciences. In order to further explore this issue and to identify priority areas for action for strengthening One Health preparedness in Europe, ECDC convened an expert consultation on 11–12 December 2017.
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States, the United Nations and civil society organisations continue to raise concerns about the humanitarian impact caused by the use of explosive weapons in populated areas (EWIPA). This issue is currently being examined from political, legal, socio-economic and humanitarian perspectives. The GICHD... has undertaken research to provide a technical perspective on the destructive effects of selected explosive weapons to inform the international debate.
The research project attempts to reduce an observed knowledge gap regarding EWIPA. It seeks to provide clarity concerning the immediate physical effects and terminology used when discussing explosive weapons. The project is guided by a group of experts dealing with weapons-related research and practitioners who address the implications of explosive weapons in humanitarian, policy, advocacy and legal fields.
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Irresponsible pharmaceutical companies fuel the proliferation of superbugs through supply chain pollution, the European Public Health Alliance (EPHA) reports. The advocacy group uncovered lapses such as dirty production and inadequate waste disposal in the production of antimicrobials in China and I...ndia, which supplies most of the antimicrobials consumed in Europe. In a briefing detailing the pollution, the EPHA urges major purchasers of antibiotics to blacklist irresponsible pharmaceutical companies, demand that the industry clean up its supply chain, introduce greater transparency on the origin of antibiotics, and review and revise procurement policies from an ethics perspective.
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This policy discussion paper is designed to give an overview of the legal and policy implications of the dealat the present time.This paper is not designed to be an exhaustive statement or exploration of all issues –rather, its purpose is to highlight the key policy and legal challenges which the ...EU-Turkey Deal has created at this early stage from the perspective of forced migrants.
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This research project is comprised of a Final Report, 5 Annexed Explosive Weapons Studies, a Terminology paper and a Simulator software tool. Motivated by its strategic goal to improve human security and equipped with subject expertise in explosive hazards, in January 2015, the GICHD established the... research project to characterise explosive weapons (CEW). The aim of this research into explosive weapons characteristics and their immediate, destructive effects on humans and structures is to contribute to the ongoing discussions on explosive weapons in populated areas, intended to reduce harm to civilians. This research does not enter into the moral or legal implications of using explosive weapon systems in populated areas, but rather examines their characteristics, effects and use from a technical perspective.
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The ethical values and behaviors are not only abstract terms, but they are refined and conceptualized byreal-life experiences. The societal context where the actions of humans can be analyzed by ethicaldecision-making is entirely relevant to deliberate on what is the right thing to do and what the m...oralagent should do, since the ethical values and principles response to the actual practices of life and to theneeds of humans in the society. This elaboration takes us to the realm of social ethics.This article reviews the definition and contextual meaning of social ethics at a broader level by givingspecial emphasis to the ethical theories and principles, focusing on the societal and public setting. Ethicswill be deliberated with social and community aspects. Based on the principle of justice and public healthethics, the concept of social ethics has been investigated concisely through the relationship between man,as a moral person, and the society in exemplification of the issues of healthcare ethics. It is argued that thetension between individualism and communitarian needs can be reconciled with the perspective of socialethics by respecting the individual autonomy without disregarding the common good and social justice.By promoting the values of social responsibility, solidarity, and social utility, social ethics has beenproposed as the basis of a rational, moral, egalitarian, pluralistic, democratic society rising on the pillars ofhuman rights and human dignity.
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Bioethics 519 (online) doi:10.1111/bioe.12145 Volume 29 Number 8 2015 pp. 488–596;
Pandemic plans recommend phases of response to an emergent infectious disease (EID) outbreak, and are primarily aimed at preventing and mitigating human-to-human transmission. These plans carry presumptive weight ...and are increasingly being operationalized at the national, regional and international level with the support of the World Health Organization (WHO). The conventional focus of pandemic preparedness for EIDs of zoonotic origin has been on public health and human welfare. However, thisfocus on human populations has resulted in strategically important disciplinary silos. As the risks of zoonotic diseases have implications that reach across many domains outside traditional public health, including anthropological, environmental, and veterinary fora, a more inclusive ecological perspective is paramount for an effective response to future outbreaks.
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The Western Pacific Regional Action Plan for the Prevention and Control of Noncommunicable Diseases (2014–2020) was developed in response to a resolution adopted at the sixty-second session of the WHO Regional Committee for the Western Pacific. The regional plan is fully harmonized with... the Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013–2020) while adding the value of actions that build on regional achievements, contexts, opportunities and perspective
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Ce document propose tout d’abord de comprendre ce qu’est un système de protection de l’enfance et pour quelles raisons Tdh entend « penser système » et se consacrer au renforcement des systèmes de protection (section 1). Il décrit ensuite le modèle d’action de référence de Tdh en ma...tière de renforcement des SPE et présente les principales interventions à mener dans cette perspective, en fonction de différents contextes (section 2). Un cadrage méthodologique et des informations d’ordre pratique viennent illustrer les manières concrètes d’intervenir en ce domaine (section 3). En annexe se trouve une description des actions composant la matrice de base à utiliser en matière de renforcement des SPE. Cette description est complétée par quelques exemples de projets et d’expériences actuellement engagés par Tdh sur le terrain en différents lieux de la planète.
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The purpose of Volume 2 is to provide a full set of reference data showing performance over the period of the previous National Health Plan 2001–2010, to provide a baseline against which performance over the next ten years can be measured, and to highlight in greater detail some of the contex...t against which the policies and strategies described in Volume 1 can be understood.
This Part A of Volume 2 provides data and context from a whole-of-country perspective. The data will be useful for provinces and national-level program staff within the National Department of Health to establish benchmarks and targets in the Five-year Strategic Implementation Plans to be developed to support implementation of this Plan. Additionally, this Volume will serve as a reference manual for all health sector stakeholders.
Original file: 77 MB
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This document addresses the issue of the medical and rehabilitative care of persons with physical disabilities. It is understood that this policy is to be integrated with the policy documents of other advisory working groups. It should also be emphasised that the physical disability work of CBM occu...rs within the context of CBM’s Disability and Development Policy, with a human rights perspective and working toward full inclusion of people with disabilities within
their society.
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Junge Geflüchtete, die gemeinsam mit ihren Familien nach Deutschland gekommen sind, finden in dieser Broschüre wichtige Informationen zu ihrer ersten Zeit in Deutschland:
Welche Rechte haben Jugendliche in Deutschland und wie kann man diese durchsetzen? Was ist Diskriminierung und was kann man da...gegen tun? Welche Perspektiven und Möglichkeiten gibt es für Schule, Ausbildung, Studium und Beruf? Wo und wie können junge Geflüchtete und ihre Familien Unterstützung, Hilfe und Beratung finden? Welche Perspektiven gibt es für den Aufenthalt und die Familienzusammenführung? Und was ist, wenn jemand aus der Familie krank wird?
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