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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 r
...
ivers, these employ different analytical methods, measure 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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To its credit, Chile has implemented a highly successful vaccine program and taken a number of other important public health measures to improve the well-being of its inhabitants. Nevertheless, these measures have proved insufficient to curb the
...
spread of the virus and ensure full compliance with Chile’s obligations to respect, protect and
fulfil the right to health. It is in this context that this report examines the human rights impacts of the pandemic and the responses of the Chilean authorities.
more
The Strategy aims to protect and improve the well-being
of society and of the individual, to protect and promote
public health, to offer a high level of security and well-being
for the general public and to increase
...
health literacy. The
Strategy takes an evidence-based, integrated, balanced and
multidisciplinary approach to the drugs phenomenon at
national, EU and international level. It also incorporates a
gender equality and health equity perspective.
more
The power of the Global Drug Policy Index lies in its key objective: to score and
rank how countries are faring in different areas of drug policy as identified in the
UN report ‘What we have learned over the last ten years: A summary of knowledge
acquired and produced by the UN
...
system on drug-related matters’,1 and derived
from the landmark UN System Common Position on Drug
more
April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cr
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uzi transmission in Latin American settings where the disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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Issue Brief 31: Antimicrobial resistance (AMR) can occur when viruses, bacteria, parasites and fungi change over time. There is no longer a response to medicines, and the infection treatment gets really difficult which increases the risk of a disesase spread, which can lead to severe
...
health problems. AMR is an increasing threat to global public health worldwide that requires cross-sectional and cross-disciplinary action. It is present in every country and is spurred by several human-made factors, including over- and/or inadequate use of antibiotics, poor hygiene and infection prevention control, and excessive usage of antibiotics outside the health care sector e.g. in life stock production.
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From February 22-23, 2023, the Wellcome Trust and the Global Task Force on Cholera Control (GTFCC) brought together researchers, decision makers, and public health implementers to participate in a virtual workshop focused on cholera and climate. Day
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1 involved a technical workshop to identify key research themes as well as the challenges, gaps, and opportunities in using climate information for cholera decision making. Day 2 was an open forum focused on information-sharing and updates from countries and partners, including a call for stronger research and data on the connection between climate and cholera.
The overarching discussion outlined the complex relationship between climate and cholera. Materials from the event – including a recording of the Day 2 open forum, key findings/messages, and a final event report – can be accessed below
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2023 is seeing intense heatwaves. According to a July 2023 briefing by the World Meteorological Association temperatures will frequently reach above 35–40°C in many places across the Mediterranean region, with temperatures in the Middle East and southeastern Türkiye reaching up to 45°C and, in
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North Africa, 44–49°C. April–May 2023 also saw temperature records broken across many parts of Asia, including Thailand, Laos and Myanmar.
The IPCC predicts that 420 million people will be exposed to extreme heat and heatwaves in the near future. Hundreds of thousands of people die from preventable heat-related causes each year, while temperature extremes and wildfires cause devastation to lives and livelihoods. According to the WMO, ‘heatwaves are amongst the deadliest natural hazards [and] heat is a rapidly growing health risk’.
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BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed.
OBJE
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CTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
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The Ministry of Education, Arts and Culture (MoEAC) has been implementing the Integrated School Health Programme in various forms since before the country attained political independence in 1990. School he
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alth goes beyond the physical health of the learner, in that it includes the holistic wellbeing of the individual learner, meaning that the school environment should be safe and conducive to learning. The National Safe Schools Framework (NSSF) is an exciting dimension of the Integrated School Health Programme. The Programme focuses on promoting the health, safety and wellbeing of learners and other school stakeholders in Namibia, and the NSSF was developed to provide practical guidance to the schools and school stakeholders on how to systematically improve the standards of school safety, and how to develop a culture of care in any school.
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J Fungi (Basel) . 2019 Aug 16;5(3):75. doi: 10.3390/jof5030075 . Namibia is a sub-Saharan country with one of the highest HIV infection rates in the world. Although care and support services are available that cater for opportunistic infections related to HIV, the main focus is narrow and predominan
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tly aimed at tuberculosis. We aimed to estimate the burden of serious fungal infections in Namibia, currently unknown, based on the size of the population at risk and available epidemiological data. Data were obtained from the World Health Organization (WHO), Joint United Nations Programme on HIV/AIDS (UNAIDS), and published reports.
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Regional and global cholera surveillance is the continuous compilation of data from affected countries, analysis and interpretation at the regional and global levels, and prompt dissemination of findings for public health action.
Currently, there are only two manufacturers with HIV POC diagnostic products prequalified by the World Health
Organization (WHO) and eligible for procurement through the United Nations. UNICEF concluded its last tender for
HIV EID and VL POC diagn
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ostic technologies in 2018 and awarded two manufacturers long-term arrangements
(LTAs) to supply WHO prequalified product
more
United- Towards Ending AIDS. The Global AIDS Strategy 2026-2031 focuses global efforts for the future of the AIDS response to end AIDS as a public health threat by 2030 and sustain the HIV response after 2030. This is a strategy uniting the world.
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The Strategy will shape the June 2026 United Nations General Assembly High-Level Meeting on Ending AIDS and its political declaration. It provides all actors in the field with guidance to overcome the challenges and to ensure effective country-led AIDS responses. The Global AIDS Strategy 2026-2031 includes new global targets for 2030 and resource needs estimates.
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The document “Guidelines for Writing Outbreak Investigation Reports” by the European Centre for Disease Prevention and Control provides practical guidance on how to prepare clear, structured, and scientifically sound reports after investigating a disease outbreak. It is mainly intended for epide
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miologists and public health professionals, particularly participants in the ECDC Fellowship Programme. The guide explains the purpose of outbreak investigation reports and describes the recommended structure and content of such reports, including sections such as background, objectives, methods, results, and conclusions. It also outlines how to present epidemiological, laboratory, and environmental findings, interpret the results, and formulate public health recommendations. Overall, the document aims to standardize outbreak reporting, improve the quality and clarity of reports, and ensure that investigation findings can effectively support public health decision-making and future outbreak prevention.
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The document “Guidelines for the Investigation and Control of Disease Outbreaks” provides practical guidance for public health professionals on how to detect, investigate, and manage outbreaks of communicable diseases. It describes the key steps
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of outbreak investigation, including confirming the outbreak, establishing a case definition, collecting epidemiological and laboratory data, identifying the source and mode of transmission, and implementing control measures. The guidelines also explain how to organize outbreak response teams, communicate findings, and document results in outbreak reports. Overall, the document aims to support systematic and effective outbreak investigations in order to control disease spread and protect public health.
more
The document “Pandemic Planning Response Guide” provides guidance for organizations on how to prepare for, respond to, and recover from a pandemic. It explains what a pandemic is and emphasizes the importance of advance planning to reduce disruptions to operations. The guide presents a structure
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d response framework based on different pandemic phases—from early alert and pre-pandemic preparation to the active pandemic phase and the recovery period afterward. For each phase, it outlines triggers, strategic actions, and practical tasks organizations should implement, such as establishing communication plans, ensuring business continuity, supporting remote work, managing supply chains, and protecting employee health and safety. In addition, the guide discusses key planning considerations like crisis communication, mental health impacts, transportation disruptions, and workforce management. Overall, the document serves as a practical template to help organizations maintain essential services and adapt their operations during a global health emergency.
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The decriminalization of drug use and possession for personal use, when implemented effectively, is a critical element in a human rights and public health-based HIV response. The group of countries that have adopted decriminalization models spans al
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l continents. This document brings together different approaches to and experiences of decriminalization of drug use and possession for personal use and provides recommendations for countries to ensure an enabling environment for the HIV response.
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What are the local beliefs and practices around illnesses and death, the transmission of disease and spirituality, which affect decision-making (around health-seeking behaviour, caring for relatives and nature of burials) and can inform effective be
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haviour change interventions for preventing Ebola in Sierra Leone?
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The Haiti & Dominican Republic Cholera Operation Plan of Action outlines the Red Cross's strategy to combat cholera on the island of Hispaniola following the 2010 outbreak in Haiti. As part of a 10-year national strategy, the plan includes an initial two-year emergency response (2014-2016) with a bu
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dget of 9.9 million Swiss francs. The approach focuses on three key areas: improving water and sanitation by repairing and expanding water systems and constructing sanitation facilities, prevention and hygiene promotion through community education and hygiene training, and preparedness and response by strengthening disease monitoring, training Red Cross volunteers, and prepositioning medical supplies. This initiative, led by the Haitian and Dominican Red Cross in collaboration with international partners and local governments, aims to reduce cholera infections and improve public health on the island.
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