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The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp
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ressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
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Updated with information on Ebola virus disease and Middle East respiratory syndrome coronavirus
A wide variety of health events ranging in severity may occur related to air transport, requiring different responses or, perhaps, no response at all. The target audience for this guidance document incl
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udes the national focal points (NFP) for the IHR and public health authorities at PoE, as well as national aviation regulatory authorities, airport operators and personnel, aircraft operators, air crew and other stakeholders involved in air transport and emergency preparedness and response to public health events
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Improving the quality of hospital antibiotic use is a major goal of WHO’s global action plan to combat antimicrobial resistance. The WHO Essential Medicines List Access, Watch, and Reserve (AWaRe) classification could facilitate simple stewardship interventions that are widely applicable globally.
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We aimed to present data on patterns of paediatric AWaRe antibiotic use that could be used for local and national stewardship interventions.
www.thelancet.com/lancetgh Vol 7 July 2019
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The education sector forms an important part of the child protection response in refugee settings, and UNHCR’s Education Strategy (2012-16) reflects a focus on refugee education as a core component of UNHCR’s protection mandate. The right to education for all children also forms part of the Unit
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ed Nations Convention on the Rights of the Child. UNHCR’s Education Strategy promotes the importance of schools as safe learning environments, emphasises improving access to quality education for refugee children and maximises the protective benefits of participation in school. It advocates for the integration of refugee children into national education systems.
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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
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, 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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Policy brief, 24 July 2020
The COVID-19 pandemic has affected older people disproportionately, especially those living in long-term care facilities. In many countries, evidence shows that more than 40% of COVID-19 related deaths have been linked to long-term care facilities, with figures being as h
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igh as 80% in some high-income countries. Concerted action is needed to mitigate the impact across all aspects of long-term care, including home- and community-based care, given that most users and providers of care are those who are vulnerable to severe COVID-19.
This policy brief provides 11 policy objectives and key action points to prevent and manage COVID-19 across long-term care. Its intended audience is policy makers and authorities (national, subnational and local) involved in the COVID-19 pandemic. The brief builds on currently available evidence on the measures taken to prevent, prepare for and respond to the COVID‑19 pandemic across long-term care services including care providers
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6 July 2021. Three new nucleic acid amplification test (NAAT) classes are endorsed by WHO and included.
The latest operational handbook includes the new classes recommended by WHO. It aims at facilitating the implementation of the WHO recommendations by the Member States, technical partners, and ot
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hers involved in managing patients with TB and DR-TB. The operational handbook provides practical information on existing and new tests recommended by WHO, step-by-step advice on implementing and scale-up testing to achieve local and national impact and lastly, model diagnostic algorithms, which are updated to incorporate the latest recommendations. An overview of budgetary considerations and information sheets on each of the newly recommended tests is provided.
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The Pharmacovigilance team in WHO aims to assure the safety of medicines and vaccines by ensuring reliable and timely exchange of information on safety issues, promoting pharmacovigilance activities throughout the Organization and encouraging participation in the WHO Programme for International Drug
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Monitoring. This text was developed in consultation with the WHO Collaborating Centre for International Drug Monitoring and the national pharmacovigilance centres participating in the WHO Programme for International Drug Monitoring.
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An evidence-informed approach for non-formal, out-of-school CSE programmes that aims to reach young people from left-behind populations
This guidance is intended to assist anyone designing and/or implementing CSE in out-of-school settings, especially in low- and middle-income countries. This includ
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es international and national civil-society organizations, community-based organizations, government departments, UN agencies, health authorities, non-formal education authorities and youth development authorities. It is also intended for anyone else involved in the design, delivery and evaluation of sexuality education programmes out of school, especially those working with the specific groups of young people addressed in the guidance.
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High salt consumption is an important determinant of high blood pressure and reducing it would improve health outcomes by lowering cardiovascular disease and therefore death rates. Reducing salt intake has been identified as one of the most effective public health measures and is one of the leading
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targets at global, regional and national levels to reduce the burden of noncommunicable diseases. The purpose of the Dietary Salt Intake Survey in the Republic of Moldova was to establish current baseline average consumption of salt (sodium), potassium and iodine through 24-hour urinary excretion testing among a random sample of the adult population (aged 18–69 years), and to assess the knowledge, attitudes, practices and behaviour around dietary salt in order to enable more efficient planning and the implementation of an effective salt-reduction strategy in the Republic of Moldova.
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The framework responds to the demand from Member States and partners for guidance on how the health sector and its operational basis in health systems can systematically and effectively address the challenges increasingly presented by climate variability and change. This framework has been designed
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in light of the increasing evidence of climate change and its associated health risks (1); global, regional and national policy mandates to protect population health (2); and a rapidly emerging body of practical experience in building health resilience to climate change (3).
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The availability of water, sanitation and hygiene (WASH) services in health care facilities, especially in maternity and primary-care settings where they are often absent, supports core aspects of quality, equity and dignity for all people. This document describes an approach for conducting a
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national situational analysis of water, sanitation and hygiene (WASH) as a basis for improving quality of care. This document describes the process from the initial preparatory stages, including triggers for action, through data collection and analysis to the dissemination of results. Each element of the approach is described and possible limitations and mechanisms to mitigate these are explored.
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The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches document is part of the WHO Guidance and technical packages on community mental health services set of publications. It provides a detailed description of person-centred and human rights-based
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approaches in mental health, and summary examples of good practice services around the world. It describes the linkages needed with housing, education, employment and social protection sectors, and presents examples of integrated regional and national networks of community-based mental health services. Specific recommendations and action steps are presented for developing community mental health services that respect human rights and focus on recovery. This comprehensive document is accompanied by a set of seven technical packages focused on specific categories of mental health services and guidance for setting up new services.
The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches is a set of publications that provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities.
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This manual summarizes key issues related to the safety of NTD medicines and their administration, with a focus on essential medicines used in mass drug administration (MDA), also called preventive chemotherapy. It can be used as a standalone reference manual, but is intended to be used in conjuncti
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on with the accompanying training modules, which provide practical instruction, and the aide-mémoires. Versions of the aide-mémoires and training modules are available respectively for both (i) programme managers and district-level health officials and (ii) community drug distributors and community health workers
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Food and nutrition security in the Democratic Republic of the Congo is subject to the relentless impact of conflict, epidemics and climate events that have persisted in the country for decades, further compounded by the global COVID-19 pandemic. Lack of infrastructure and investment in agriculture,
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health and human capital development combine to impede progress towards the achievement of Sustainable Development Goals 2 and 17. While there are several legal instruments and policies that promote food and nutrition security, poor coordination, weak national capacity and exponential population growth present serious obstacles to the achievement of zero hunger. Political instability and siloed sectoral responses to humanitarian and development needs have also affected results to date.
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Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.
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These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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The overall goal of this strategy is to ensure accurate understanding of the
benefits of covid-19 vaccination and alleviate apprehension about the vaccine, to ensure its acceptance and encourage uptake across various audiences.
Objectives
x Create demand, promote acceptability and accessibility o
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f COVID-19
vaccine among at least 90% of the general public.
x Develop appropriate messages and identify channels to communicate
the potential benefits and risks of the vaccine to all concerned parties,
including decision-makers at all levels.
x Provide timely and accurate information to address misinformation,
rumors and other crisis situations.
x Effectively mobilize and empower communities to ensure participation
and ownership of the vaccination process
x Strengthen communication mechanisms and partnerships among key
stakeholders to support the national communication effort.
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More than two years since the first SARS-CoV-2 infections were reported, the COVID-19 pandemic remains an acute global emergency. In this Strategic Preparedness, Readiness and Response plan for 2022, WHO sets out a number of key strategic adjustments that, if implemented rapidly and consistently at
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national, regional, and global levels, will enable the world to end the acute phase of the pandemic.
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The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities have no water services, and 10% have no sanitation services. This means that 1.8 billion people use facilities that l
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ack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.
This report also describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together.
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This report provides updated data on suicide in the Region of the Americas and is issued every five years, this being the fourth edition. In addition to including analysis similar to previous reports (suicide according to age, sex, as well as methods used), this report includes an expanded set of an
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alysis on risk factors for suicide in the Americas: the analysis of the annual age-standardized gender-specific suicide mortality rate trends over time by country and sub-region and to identify points of inflection, and evaluates the association of specific risk factors on country-level suicide mortality rates.
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