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For the first time in almost 50 years there are two new drugs for the treatment of drug-resistant TB (DR-TB): bedaquiline and delamanid. There has also been increased attention given to the safety and efficacy of “re-purposed” drugs that have be
...
en widely used to treat other infections but are also showing promise in the treatment of DR-TB, including linezolid and clofazimine. This special supplemental guide has been developed for nurses, because it is essential that nurses be provided with material that maximizes their ability to provide optimal support to patients who are receiving new and re-purposed drugs
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Benchmarking is a strategic process often used by businesses and institutes to standardize performance in relation to the best practices of their sector. The World Health Organization (WHO) and partners ha
...
ve developed a tool with a list of benchmarks and corresponding suggested actions that can be applied to implement the International Health Regulations 2005 (IHR) and strengthen health emergency prevention, preparedness, response and resilience capacities.
The first edition of the benchmarks was published in 2019 to support countries in developing, implementing and documenting progress of national IHR or health security plans (e.g. national action plan for health security (NAPHS), national action plan for emerging infectious diseases, public health emergencies and health security and other country level plans for health emergencies). The tool has been updated to incorporate lessons from COVID-19 and other health emergencies, to align with the updated IHR monitoring & evaluation framework (IHR MEF) tools and the health systems for health security framework, and to support strengthening health emergency prevention, preparedness, response and resilience (HEPR) capacities and the Preparedness and Resilience for Emerging Threats (PRET) initiative.
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The objectives of this guideline are the same as those of the 2011 edition, namely to provide evidence-based normative guidance on interventions to improve adolescent morbidity and mortality by reducing the chances of early pregnancy and its resulting poor health outcomes. The specific objectives of
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the guideline were to: 1. identify effective interventions to prevent early pregnancy by influencing factors such as early marriage, coerced sex, unsafe abortion, access to contraceptives and access to maternal health services by adolescents; and 2. provide an analytical framework for policy-makers and programme managers to use when selecting evidence-based interventions to prevent early pregnancy and negative health outcomes when they occur that are most appropriate for the needs of their countries and context. The recommendations and best practice statements described in this document aim to enable evidence-based decision-making with respect to preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income country contexts.
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Atlas of African Health Statistics 2022: Health situation analysis of the WHO African Region
Since 2019, we have been implementing Phase 2 of the regional Transformation Agenda, which informs and a
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ligns with the global WHO Transformation, to ensure WHO is accountable, driven by re- sults and providing value for money in the pursuit of better health. Our global priority in this period is to contribute to delivering on the triple billion targets of expanding universal health coverage, protecting people from emergencies, and promoting health and well-being for people across the Region.
This year’s Atlas of African Health Statistics is being produced in the context of the COVID-19 pandemic that we have been expe- riencing for over two years. The ongoing coronavirus pandemic, together with other health emergencies in the WHO African Re- gion, is yet again testing the strength and resilience of our health systems. Indeed, the impact of COVID-19 is visible in the disruption of services. The report also presents the latest data for more than 50 health-related indicators of the Sustainable Development Goals and WHO’s “triple billion” targets and provides comprehensive country-level statistics using the results chain of the AFRO frame- work of actions for strengthening health systems to achieve UHC and the health-related SDGs.
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The Socio-Economic Impact of People Living with HIV at the Household Level in Myanmar
Cercone, James; Pinder, Étoile; Pothuis, Michal et al.
The Republic of the Union of Myanmar, Ministry of Health and Sports; UNDP
(2016)
C1
The study collected data on the impact of HIV-related diseases on income, revenues, economic dependency, consumption, education, health, food security, stigma, discrimination, quality of life, and migration. The study also assessed people living with
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chronic diseases in order to compare the impact of living with HIV/AIDS with the impact of living with a chronic disease.
Stigma, discrimination, and socio-economic exclusion continue to affect the rights and socio-economic opportunities of people living with HIV in Myanmar. Households with a family member who has HIV, have lower incomes, fewer assets and lower home-ownership, compared to households that are not affected by HIV. They also have more household debt, and their families pay a higher rate of interest compared to families not affected by HIV. more
Stigma, discrimination, and socio-economic exclusion continue to affect the rights and socio-economic opportunities of people living with HIV in Myanmar. Households with a family member who has HIV, have lower incomes, fewer assets and lower home-ownership, compared to households that are not affected by HIV. They also have more household debt, and their families pay a higher rate of interest compared to families not affected by HIV. more
In 2023, 6.7 million [6.1 million–7.5 million] people living with HIV were residing in Asia and the Pacific, making this the world’s largest epidemic after eastern and southern Africa. The region accounts for a quarter of annual new HIV infectio
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ns globally (23%). People from key populations and their sex partners are disproportionately affected.
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Direct acting antivirals (DAAs) have revolutionized treatment for hepatitis C. Combi-
nations of DAAs can cure infection with HCV in 12 weeks, are highly effective and
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have limited side-effects. Affordability of DAAs has improved significantly, but access remains lim-
ited. Initially, due to their high prices, affordability of DAAs was limited in high-, middle- and low-
income countries alike. Now there is a divide between those countries where, because of intellectual
property barriers, prices have remained (very) high and other countries where generics are, or can be,
available at much lower prices. The result is a dual market
more
Through technical consultations with countries and partners, WHO has led the development of Preparedness and Resilience for Emerging Threats Module 1: Planning for respiratory pathogen pandemics. Ve
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rsion 1.0. The Module, currently available as an advanced draft, builds on previous pandemic lessons and guidance, and has the following new elements:
It presents an integrated and efficient respiratory pathogen pandemic planning approach covering both novel pathogens and those known to have pandemic potential;
It enables coherence in addressing pathogen-agnostic and pathogen-specific elements for better preparedness;
It gives an organizing framework including operational stages and triggers for escalation and de-escalation between pandemic preparedness and response periods;
It contextualizes 12 IHR (2005) core capacities within the five components of health emergency preparedness, response and resilience (HEPR), from the respiratory threats perspective; and
It describes the critical sectors for respiratory pathogen pandemic preparedness to trigger multisectoral collaboration.
WHO will finalize and publish this Module after a global technical meeting that will be held on 24-26 April 2023.
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Policy Brief. Good practice statement: When planning and implementing a response for HIV, viral hepatitis and sexually transmitted diseases (STIs), policy-makers and providers should be aware that
counselling behavioural interventions aimed to change behaviours to reduce risks associated
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with these infections for key populations have not been shown to have an effect on HIV, viral
hepatitis and STIs’ incidence nor on risk behaviour such as condom use and needle/syringe
sharing. Counselling and information sharing, not aimed at changing behaviours, can be a key
component of engagement with key populations and, when provided, it should be in a nonjudgemental manner, alongside other prevention interventions and with involvement of peers
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Group psychological help for adults impaired by distress in communities exposed to adversity
With this manual, the World Health Organization (WHO) is responding to requests from colleagues around t
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he world for a group version of the manual Problem Management Plus (PM+), which was developed for adults impaired by distress in communities who are exposed to adversity. Aspects of Cognitive Behavioural Therapy (CBT) have been changed to make them feasible in communities that do not have many specialists. To ensure maximum use, the intervention is developed in such a way that it can help people with depression, anxiety and stress, whether or not exposure to adversity has caused these problems. It can be applied to improve aspects of mental health and psychosocial well-being no matter how severe people’s problems are.
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Epilepsy is one of the world’s most common chronic neurological disorders. Roughly 50 million people
suffer from it, 5 million of them in the Region of the Americas . Nevertheless, it is estimated that over
50% of these people in Latin America and the Caribbean
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have no access to services. Furthermore,
the stigma attached to people with epilepsy is a barrier to the exercise of their human rights and social
integration.
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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 s
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ervices, and 10% have no sanitation services. This means that 1.8 billion people use facilities that lack 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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Palliative care for older people: better practices
Hall, S.; H. Petkova, A.D. Tsouros, et al.
World Health Organization WHO, Regional Office for Europe, et al.
(2011)
C_WHO
This publication aims to provide examples of better palliative care practices for older people to help those involved in planning and supporting care-oriented services most appropriately and effectively. Examples have been identifi ed from
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literature searches and from an international call for examples through various organizations, including the European Association of Palliative Care and the European Union Geriatric Medicine Society. Some examples consider how to improve aspects within the whole health system; specifi c smaller examples consider how to improve palliative care education, support in the community, in hospitals or for specifi c groups of people, such as people in nursing homes and people with dementia and their families. Some examples await rigorous evaluation of effectiveness, and more research is needed in this fi eld, especially the cost–effectiveness and generalizability of these initiatives.
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Women, the elderly, adolescents, youth, and children,
persons with disabilities, indigenous populations, refugees,
migrants, and minorities experience the highest degree
of socio-economic marginalization. Marginalized people
become even more vul
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nerable in emergencies.1 This is due
to factors such as their lack of access to effective surveillance
and early-warning systems, and health services. The
COVID-19 outbreak is predicted to have significant impacts
on various sectors.
The populations most at risk are those that:
• depend heavily on the informal economy;
• occupy areas prone to shocks;
• have inadequate access to social services or political
influence;
• have limited capacities and opportunities to cope and
adapt and;
• limited or no access to technologies.
By understanding these issues, we can support the capacity
of vulnerable populations in emergencies. We can give
them priority assistance, and engage them in decision-making
processes for response, recovery, preparedness, and
risk reduction.
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Providing quality, stigma-free services is essential to equitable health care for all and achieving global HIV goals and broader Sustainable Development Goals related to health. Every person has the right to the highest attainable standard of physical and mental health. Countries
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have a legal obligation to develop and implement legislation and policies that guarantee universal access to quality health services and address the root causes of health disparities, including poverty, stigma and discrimination.
The health sector is uniquely placed to lead in addressing inequity, assuring safe personcentred care for everyone and improving social determinants of health by overcoming taboos and discriminatory or stigmatizing behaviours associated with HIV, viral hepatitis and sexually transmitted infections (STIs). Improving health care quality and reducing stigma work together to enhance health outcomes for people living with HIV. Together, they make health care services more accessible, trustworthy and supportive. This encourages early diagnosis, consistent treatment and improved mental well-being. Thus, people living with HIV are more likely to engage with and benefit from health care services, leading to improved overall health.
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Evidence shows that FGM can cause several physical, mental and sexual health complications in girls and women, and in newborns. Health-care providers play an important role in supporting girls and women living with FGM, and improving their health an
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d well-being. They are in a unique position to influence and change the attitudes of their patients about FGM.
WHO is committed to scaling up the health-sector response to address FGM prevention and care. One aspect is to strengthen the quality of FGM prevention and care services by building the capacity of health-care providers. Several guidance materials have been produced to target health-care providers. These include FGM content for training curricula, clinical guidelines and a clinical handbook.
This training manual complements previous publications by building person-centred communication skills specifically for FGM prevention.
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Problem Management Plus (PM+)
recommended
Individual psychological help for adults impaired by distress in communities exposed to adversity.
The manual describes a scalable psychological intervention called Problem Management Plus (PM+) for adults impaired by distress in communities who ar
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e exposed to adversity. Aspects of Cognitive Behavioural Therapy (CBT) have been changed to make them feasible in communities that do not have many specialists. To ensure maximum use, the intervention is developed in such a way that it can help people with depression, anxiety and stress, whether or not exposure to adversity has caused these problems. It can be applied to improve aspects of mental health and psychosocial well-being no matter how severe people’s problems are.
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2nd edition. The 2018 Roadmap incorporates an additional critical population: adolescents. Despite making up 1 in 6 of the world’s people, adolescents have been largely overlooked as global momentum to address TB has grown. Spanning the ages of 10
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–19 years, adolescents are both at risk of TB and represent an important population for TB control. They often present with infectious TB and frequently have multiple contacts in congregate settings, such as schools and other educational institutions. Nevertheless, few countries capture TB data in suitably age-disaggregated ways to allow full understanding of its impact in this group and even fewer provide the adolescent-friendly services our young people need to access diagnosis and care.
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Adolescence, defined as the period between 10 and 19 years of age, is a developmental stage during which many psychosocial and mental health challenges emerge. There is a well-established link between mental health and HIV outcomes. Adolescents and young adults living
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with HIV typically have additional mental health needs linked to their experiences of living with and managing a chronic illness, along with prevailing stigma and discrimination. Mental health promotion and prevention is thus a critical priority for this group.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera
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lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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