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his document, a first of its kind, clearly sets out the standards for rehabilitation and provides guidance on building or strengthening the capacity of EMTs in this area.The impo
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rtance of early rehabilitation for functional outcomes is well documented. Rehabilitation needs can persist far beyond the departure of EMTs; therefore, close, supportive collaboration must be established with local services. Emergency response presents an opportunity to rebuild devastated health systems and build local rehabilitation capacity. This document emphasizes the importance of aligning practices to the local context and maximizing opportunities for training and mentorship. The minimum standards and recommendations described will result in faster access of patients to rehabilitation services and equipment and a better transition between EMTs and local health facilities.
Available in English, German, Arabic, Chinese
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Antimicrobial resistance (AMR) surveillance plays an important role in the early detection of resistant strains of public health importance and prompt response to outbreaks in hospitals and the comm
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unity. Surveillance findings are needed to inform medical practice, antibiotic stewardship, and policy and interventions to combat AMR. Appropriate use of antimicrobials, informed by surveillance, improves patients’ treatment outcomes and reduces the emergence and spread of AMR. This protocol describes the steps and procedures to establish/enhance AMR surveillance in Latin America and the Caribbean.
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he WHO South-East Region in 2019 accounted for nearly a million missing TB patients from the estimated incidence. Active case-finding (ACF) or systematic screening for tuberculosis is an important tool to reach out to missing TB
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patients. When appropriately implemented, the activity is cost effective, helps to reduce diagnosis and treatment delays, and prevents the spread of the disease. This document presents an analysis of published ACF studies from the Region. It can be used by Member States for effective planning, implementation and monitoring of these activities.
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There is a broad consensus nowadays that the Earth is warming up as a result of greenhouse gas emissions caused by anthropogenic activities. It is also clear that current trends in the fields of ene
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rgy, development and population growth will lead to continuous and ever more dramatic climate change. This is bound to affect the fundamental prerequisites for maintaining good health: clean air and water, sufficient food and adequate housing. The planet will warm up gradually, but the consequences of the extreme weather conditions such as frequent
storms, floods, droughts and heat-waves will have sudden onset and acute repercussions. It is widely accepted that climate change will have an impact on the spread of infectious diseases in Europe, which is likely to bring about new public health risks in the majority of cases. Transmission of infectious diseases depends on a number of factors, including climate and environmental elements. Foodborne and waterborne diseases, for instance, are associated with high temperatures. Disease-transmitting vectors (e.g. mosquitoes, sandflies and ticks) are highly sensitive to climate conditions, including temperature and humidity; their geographical distribution will widen as climate conditions change, potentially allowing them to spread into regions where they are not currently able to live.
The primary purpose of this manual on climate change and infectious diseases is to raise the awareness and the level of knowledge of health workers at national, regional and local levels in the former Yugoslav Republic of Macedonia on the health risks associated with climate change and infectious diseases. This manual was devel-
oped as part of the WHO Regional Office for Europe project, Protecting health from climate change: a seven–country initiative, implemented with financial support from the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is comm
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on in rural tropical communities in West and Central Africa, where access to proper health care is limited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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Cholera is a major health risk in many parts of the world, affecting millions of people every year. Since mid-2021, the world has been facing an acute upsurge
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of the 7th cholera pandemic, which is characterized by the number, size and concurrence of multiple outbreaks, the spread to areas that had been free of cholera for decades and alarmingly high mortality rates. The mortality associated with these outbreaks is of particular concern as many countries have reported higher case fatality ratios (CFR) than in previous years
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence
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of a CHW programme. In this study, we evaluated expanding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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This document provides technical guidance for manufacturers seeking World Health Organization (WHO) prequalification of in vitro diagnostic devices (IVDs) for malaria, with a focus on rapid diagnostic tests (RDTs) for symptomatic
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patients. It summarises the minimum performance requirements, including analytical and clinical performance standards, and emphasises considerations relating to diverse specimen types, testing environments and user populations in low- and middle-income countries. The guidance is aligned with the criteria and prequalification processes of the WHO Global Malaria Programme, while clarifying that demonstration of clinical utility is outside the scope of prequalification.
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This document provides technical guidance for manufacturers seeking World Health Organization (WHO) prequalification of in vitro diagnostic devices (IVDs) for malaria, with a focus on rapid diagnostic tests (RDTs) for symptomatic
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patients. It summarises the minimum performance requirements, including analytical and clinical performance standards, and emphasises considerations relating to diverse specimen types, testing environments and user populations in low- and middle-income countries. The guidance is aligned with the criteria and prequalification processes of the WHO Global Malaria Programme, while clarifying that demonstration of clinical utility is outside the scope of prequalification.
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This Clinic Supervisor’s Manual is helpful for focusing managers on the key elements of integrated primary health care as they simultaneously integrate new interventions for HIV/AIDS, tuberculosis, and malaria. This tool contains 12 sections. Sect
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ion 1 explains how to use the manual. Section 2 helps the clinic supervisors organize their supervisory visit. The remainder of the sections focus on a number of key areas during a clinic supervision visit.
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Guideline ‒ Alternative mass drug administration regimens to eliminate lymphatic filariasis
recommended
Lymphatic filariasis is a vector-borne neglected tropical disease that causes damage of the lymphatic system and can lead to lymphoedema (elephantiasis) and hydrocele in infected individuals. The global baseline estimate
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of persons affected by lymphatic filariasis is 25 million men with hydrocele and over 15 million people with lymphoedema. At least 36 million persons remain with these chronic disease manifestations. The disease is endemic in 72 countries. In 2016, an estimated total population of 856 million were living in areas with ongoing transmission of the causative filarial parasites and requiring mass drug administration (MDA). Lymphatic filariasis disfigures and disables, and often leads to stigmatization and poverty. Hundreds of millions of dollars are lost annually due to reduced productivity of affected patients. WHO has ranked the disease as one of the world’s leading causes of permanent and long-term disability.
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Ethiopia has been repeatedly affected by conflict, flooding, drought, and disease outbreaks in the past years. As of January 2024, the country is actively responding to the longest recorded cholera outbreak which started in August 2022, recurrent me
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asles outbreaks which started in August 2021, and the highest number of malaria cases reported since 2017. The El Niño phenomenon is expected to cause further havoc up to July 2024, by causing drought in some parts of the country, and flooding in others. Food insecurity due to lost harvest and livestock is aggravating already high malnutrition rates, negatively impacting morbidity and mortality.
The Health Cluster is closely collaborating with the Ministry of Health (MOH) to prepare for, prevent, and respond to public health emergencies by mobilizing resources to enable health partners to provide life-saving health services to vulnerable populations.
In an environment with ever-increasing needs and decreased funding, the below priorities for 2024 and 2025 have been identified: 1 Strengthen advocacy for longer-term, development funding to address root causes of recurrent disease outbreaks, including through the Humanitarian-Development-Peace Nexus 2 Advocate for increased access to quality health services, with a strong focus on:
sexual and reproductive health services (including for survivors of sexual and gender-based violence)
inclusion of people with disabilities, older people, and people living with HIV
remote populations through inclusion of Mobile Health Teams (MHT) as part of the health system 3 Standardize health services provided by Health Cluster partners through the implementation of Essential Health Care packages, aligned with existing MOH guidance, aimed at ensuring quality service delivery for affected populations, especially at community level 4 Strengthen quality of, and access to data for needs analysis and informed decision-making 5 Strengthen subnational coordination, with increased focus on zones and local health partners
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Interim Guidance 31 march 2020
WHO has established a shipment mechanism to expedite and cover the costs of the shipment of clinical samples from patients
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with suspected COVID-19 from the country of collection to one of the WHO reference laboratories providing confirmatory molecular testing for COVID-19. This document explains the process and documentation required for shipment of specimens.
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Overview: In this course, you will learn about the causes of unsafe injection practices, how to safely give injections, and how to safely dispose of needles and other sharps. You will also learn wha
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t to do when needle-stick injuries occur, how to manage potential exposures, and ways to protect yourself, the staff and patients in your facility, and your community.
Course duration: Approximately 2 hours.
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In 2022, a total of 6,131 confirmed malaria cases were reported across the EU/EEA. Of these, 5,375 had a known importation status and nearly all (99.8%) were travel-related. Only 13 infections were
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acquired within Europe, with seven occurring in France, three in Germany, two in Spain and one in Ireland. A distinct seasonal peak was observed from July to September, reflecting travel to malaria-endemic regions. Notification rates were higher among men than women, with a male-to-female ratio of 2:1. France reported the highest number of cases, followed by Germany, Spain, Italy and Belgium. After dropping sharply in 2020 due to travel restrictions imposed during the pandemic, overall notification rates increased again in 2021 and 2022, reaching 0.8 cases per 100,000 people. These findings emphasise that malaria in Europe is predominantly an imported disease closely linked to international travel, with sporadic local transmission being rare.
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Environmental Research Volume 151, November 2016, Pages 115-123
Dengue is the world’s most important arboviral disease in terms of number of peo
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ple affected. Over the past 50 years, incidence increased 30-fold: there were approximately 390 million infections in 2010. Globalization, trade, travel, demographic trends, and warming temperatures are associated with the recent spread of the primary vectors Aedes aegypti and Aedes albopictus and of dengue. Overall, models project that new geographic areas along the fringe of current geographic ranges for Aedes will become environmentally suitable for the mosquito’s lifecycle, and for dengue transmission. Many endemic countries where dengue is likely to spread further have underdeveloped health systems, increasing the substantial challenges of disease prevention and control. Control focuses on management of Aedes, although these efforts have typically had limited effectiveness in preventing outbreaks. New prevention and control efforts are needed to counter the potential consequences of climate change on the geographic range and incidence of dengue, including novel methods of vector control and dengue vaccines.
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The global cholera statistics for 2024, showing an increase in both the number of people who fell sick and died from the disease.
Reported cholera cases rose by 5% and deaths by 50% in 2024 compare
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d to 2023, with more than 6000 people dying from a disease that is both preventable and treatable. While these numbers are themselves alarming, they are underestimates of the true burden of cholera.
Weekly epidemiological record WER No 36, 2025, 100, 347–364
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Therapy for MDR-TB is extremely long, complex and burdensome to both patients and health care systems. A single diagnosis can require two years of treatment, or longer. When treating children, there
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are significant additional barriers treating children with MDR-TB. There is limited data on the pharmacokinetics of second-line TB drugs in children, and almost none are in child-friendly formulations. Nonetheless, there is continued work on second-line drugs to fight MDR-TB. The Sentinel Project has created a complex set of dosing recommendations for administering second-line drugs to children
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In preparing this paper, the Pharmacovigilance Group of the Pan American Health Organization’s Pan American Network for Drug Regulatory Harmonization (PANDRH) adopted the perspective of PAHO/WHO,
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which considers Pharmacovigilance, an essential component of public health programs. Its intention was to facilitate the development of pharmacovigilance systems in the Region of the Americas and improve, strengthen, and promote the adoption of good practices to improve safety for patients and the general population, based on the needs of the Region.
Document also available in Spanish and Portuguese!
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