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Keeping communities at the centre of efforts to eliminate lymphatic filariasis: learning from the past to reach a future free of lymphatic filariasis
Krentel, A.; Gyapong, M.; McFarland, D.A.; Ogundahunsi, O.; Titaley, C.R.; Addiss, D.G.
Oxford Academic - International Health
(2021)
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Since the launch of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) in 2000, more than 910 million people have received preventive chemotherapy for lymphatic filariasis (LF) and many thousands have received care for chronic manifestat
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ions of the disease. To achieve this, millions of community drug distributors (CDDs), community members and health personnel have worked together each year to ensure that at-risk communities receive preventive chemotherapy through mass drug administration (MDA). The successes of 20 y of partnership with communities is celebrated, including the application of community-directed treatment, the use of CDDs and integration with other platforms to improve community access to healthcare. Important challenges facing the GPELF moving forward towards 2030 relate to global demographic, financing and programmatic changes. New innovations in research and practice present opportunities to encourage further community partnership to achieve the elimination of LF as a public health problem. We stress the critical need for community ownership in the current Covid-19 pandemic, to counter concerns in relaunching MDA programmes for LF.
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Vector-borne diseases are responsible for 17% of the global burden of communicable diseases and more than 500 000 deaths annually. The ambitious global targets for the control of vector-borne diseas
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es come in the context of the (re-)emergence of diseases, increasing resistances to insecticides and uncertainty related to the financing of global vector control efforts. The United Nations 2030 Agenda with its related Sustainable Development Goals (SDGs), the New Urban Agenda adopted at the United Nations Conference on Housing and Sustainable Urban Development (Habitat III)
in Quito in 2016 and WHO’s Global vector control response 2017–2030 (WHO, 2017a) emphasize the value of elevating multisectoral actions and strategies that extend beyond the health sector to the core of integrated vector control.
This policy brief underlines the important role housing conditions have in the transmission of vector-borne diseases and showcases interventions and policies the housing sector can contribute to effective, integrated and intersectoral vector-borne diseases management.
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On Global Handwashing Day, WHO and UNICEF have released the first-ever global Guidelines on Hand Hygiene in Community Settings to support governments and practitioners in promoting effective hand hy
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giene outside health care – across households, public spaces and institutions. Framing hand hygiene as a public good and a government responsibility, the Guidelines translate evidence into ready-to-adopt actions that enable sustainable access to effective hygiene services. This will reduce diarrhoeal disease, acute respiratory infections and other preventable illnesses, strengthening routine public health where people live, work, visit and study, and emergency preparedness, including outbreaks like cholera.
Despite clear benefits, 1.7 billion people still lacked basic hand hygiene services at home in 2024, including 611 million with no facility at all. Meeting the 2030 target will require accelerated progress – about a doubling in the global rate, and much faster in specific settings (up to 11-fold in least-developed countries and 8-fold in fragile contexts). Hand hygiene remains one of the most cost-effective health investments, reducing diarrhoea by 30% and acute respiratory infections by 17%, with large, measurable gains for population health.
“Clean hands save lives, but results at scale require policy, financing and accountability,” said Dr Ruediger Krech, Director a.i, Department of Environment, Climate Change, One Health & Migration at the World Health Organization. “These Guidelines help countries move beyond fragmented projects to government-led systems that make soap, water, and conditions conducive to everyday hand hygiene the norm.”
“Children and young people pay the highest price when basic hygiene is out of reach,” said Cecilia Scharp, Director, Water Sanitation and Hygiene (WASH) Team, Programme Group, UNICEF. “These Guidelines provide practical steps to ensure facilities are accessible when they need to be – in homes, schools, markets, and transport hubs – so every child can learn, play and thrive with dignity.”
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This document summarizes the results of the WHO-commissioned full value proposition for new tuberculosis (TB) vaccines. The assessment was commissioned to provide early evidence for national and global decision-makers involved in TB vaccine developm
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ent and implementation, who include stakeholders involved in vaccine research, financing, regulation and policy-making, manufacturing, introduction and procurement. The goal is to accelerate development of effective vaccines against TB and their rapid introduction into countries.
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WHO, in partnership with the International Society for Prosthetics and Orthotics (ISPO) and the United States Agency for International Development (USAID), has published global standards for prosthetics and orthotics. Its aim is to ensure that prost
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hetics and orthotics services are people-centred and responsive to every individual’s personal and environmental needs. The standards advocate for the integration of prosthetics and orthotics services into health services, under universal health coverage. Implementation of these standards will support countries to fulfil their obligations under the Convention on the Rights of Persons with Disabilities and towards the Sustainable Development Goals, in particular Goal 3: Ensure healthy lives and promote well-being for all at all ages.
The standards provide guidance on the development of national policies, plans and programmes for prosthetics and orthotics services of the highest standard. The standards are divided into two documents: the standards and an implementation manual. Both documents cover four areas of the health system:
policy (governance, financing and information);
products (prostheses and orthoses);
personnel (workforce);
and provision of services.
The Standards have been developed through consultation with experts from around the globe via a steering group, development group and external review group.
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WHO, in partnership with the International Society for Prosthetics and Orthotics (ISPO) and the United States Agency for International Development (USAID), has published global standards for prosthetics and orthotics. Its aim is to ensure that prost
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hetics and orthotics services are people-centred and responsive to every individual’s personal and environmental needs. The standards advocate for the integration of prosthetics and orthotics services into health services, under universal health coverage. Implementation of these standards will support countries to fulfil their obligations under the Convention on the Rights of Persons with Disabilities and towards the Sustainable Development Goals, in particular Goal 3: Ensure healthy lives and promote well-being for all at all ages.
The standards provide guidance on the development of national policies, plans and programmes for prosthetics and orthotics services of the highest standard. The standards are divided into two documents: the standards and an implementation manual. Both documents cover four areas of the health system:
policy (governance, financing and information);
products (prostheses and orthoses);
personnel (workforce);
and provision of services.
The Standards have been developed through consultation with experts from around the globe via a steering group, development group and external review group.
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This report explores the intersection of tuberculosis (TB) and climate change, highlighting how climate-related challenges such as food and water insecurity, displacement, and disrupted healthcare access amplify TB risk. Intended as a resource for policymakers, researchers, development partners,
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financing institutions, and civil society, it advocates for recognizing TB as a climate-sensitive disease. The report promotes research, calls for increased financing, and provides an evidence-based framework to inform mitigation, adaptation, and resilience strategies in the global TB response.
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Rwanda Malaria Strategic Plan 2020–2024
Ministry of Health, Rwanda; Rwanda Biomedical Centre (RBC)
Ministry of Health, Republic of Rwanda
(2020)
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The Rwanda Malaria Strategic Plan 2020–2024 outlines Rwanda’s national strategy to reduce malaria morbidity and mortality by at least 50% compared to 2019 levels. The vision is a malaria-free Rwanda contributing to socioeconomic development.
The plan includes strengthening prevention through lo
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ng-lasting insecticide-treated nets, indoor residual spraying, and larval source management; ensuring universal access to testing and treatment; improving surveillance and data use; and enhancing program management, coordination, and financing. It also emphasizes community engagement and behavior change to ensure at least 85% of the at-risk population adopts protective practices.
The strategy builds on past lessons, involves multi-sectoral collaboration, and aligns with global malaria goals. It highlights equity, quality services, and evidence-based interventions as guiding principles, aiming to mobilize national and international resources for sustained impact.
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COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic
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health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios.
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The COVID-19 pandemic disrupted health systems in 2020, but it is unclear how financial hardship due to out-of-pocket (OOP) health-care costs was affected. We analysed catastrophic
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health expenditure (CHE) in 2020 in
five countries with available household expenditure data: Belarus, Mexico, Peru, Russia, and Viet Nam. In Mexico and Peru, we also conducted an analysis of drivers of change in CHE in 2020 using publicly available data.
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One approach to development assistance for health, or health aid, emphasizes the ex ante selection of cost-effective health interventions, an appro
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ach that began with the World Development Report (1993) on Investing in Health and has since been adopted by the Effective Altruism community. But just how much of health aid is cost-effective? In this paper, we examine projects in the Organisation for Economic Co-operation and Development (OECD) Creditor Reporting System, the standard dataset that measures and characterizes development assistance for health, for the
years 2019 to 2021, and count the number of projects that refer to interventions from a list of highly cost-effective interventions as defined by the Disease Control Priorities Project, third edition. This exploratory quantitative analysis indicates that 61% of projects used a key word/phrase of a costeffective intervention. There were 11.9 interventions mapped per project on average. There is little evidence that donors tailor the set of interventions to country income levels by cost-effectiveness.
Policymakers may benefit from reviewing the full portfolio of interventions covered by domestic and external resources.
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Rising levels of inflation, debt and macrofiscal tightening are putting expenditures on the social sectors including health under immense scrutiny. Already, there are worrying signs of reductions in social sector investments. However, even before th
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e pandemic, evidence showed the significant returns on investments in health equity and its social determinants. Emerging data and trends show that these potential returns have increased during the COVID-19 pandemic - investments in social determinants can mitigate widespread reductions in human capital and the increasing likelihood of costly syndemics, while promoting access to healthcare innovations that have thus far been inequitably distributed. Therefore, we argue that, despite immediate fiscal pressures, this is exactly the time to invest in health equity and its broader social determinants, as the returns on such investments have never been greater.
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Development assistance for health (DAH)
plays a vital role in supporting health programmes in lowand middle-income countries. While DAH has historically
focused on infectious diseases and maternal
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and child
health, there is a lack of comprehensive analysis of DAH
trends, strategic shifts and their impact on health systems
and outcomes. This study aims to provide a comprehensive
review of DAH from 1990 to 2022, examining its evolution
and funding allocation shifts.
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The motivations behind China’s allocation of health aid to Africa remain complex due to limited information on the details of health aid project activities. Insufficient knowledge about the purpos
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e of China’s health aid hinders our understanding of China’s comprehensive role in supporting Africa’s healthcare system. To address this gap, our study aimed to gain better insights into China’s health aid priorities and the factors driving these priorities across Africa. To achieve this, we utilized AidData’s Chinese Official Finance Dataset and adhered to the Organisation for Economic Co-operation and Development (OECD) guidelines.
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Most foreign aid comes in one of two forms: either we pay a person or an institution today in exchange for delivering some beneficial activity in the future, or we observe something bad happen to them and then give them support to recover from it. This kind of aid is simple to design and deliver,
b
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ut in the former case has limits in how sharply it incentivizes success and effort from a range of actors and in the latter case leads to the inefficient and undignified “begging bowl” approach to humanitarian financing. In what follows, I identify a broad family of alternative approaches, which
can loosely be grouped together as “contractually contingent financing,” and explain why they are still relatively underused.
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Drawing on the World Health Organization’s package of NCD best buys, the report demonstrates how these evidence-based measures can help countries reduce premature deaths, strengthen health systems
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, and advance progress towards the Sustainable Development Goals. It provides policymakers, donors, advocates, and partners with a clear economic and social rationale for scaling up implementation of proven solutions. By framing NCD prevention and control as both a health and development priority, the report offers a roadmap for action that delivers benefits across populations, economies, and generations. The evidence is clear: investing in WHO’s best buys is not only possible—it is imperative. The time to act is now.
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This Guide is part of WHO’s overall programme of work on Political Economy of Health Financing Reform: Analysis and Strategy to Support UHC. The impetus for this work came from demands for more co
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ncrete evidence, recognition and integration of political economy issues within
health financing, and overall system, reform design and implementation processes. This Guide is complementary to WHO’s Health Financing Progress Matrix assessment, as well as Health Financing Strategy development guidance. In this way, it promotes an embedded political
economy analysis approach that can be used in conjunction with other health financing assessments and guidance. The political economy framework can also be extended and easily adapted to broader health policy reforms.
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This paper outlines the background to and design of the Health Financing Progress Matrix (HFPM), WHO’s standardized qualitative approach to assessing country
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health financing systems. Primarily qualitative in nature, the HFPM assesses a country’s health financing institutions, processes, policies and their implementation, benchmarked against good practice in the context of universal health coverage (UHC). The paper also details processes which ensure that country assessments are credible. While health financing is only one of the core functions of a health system, it significantly influences both the extent to which the population accesses health services, and the extent to which they face financial hardship in the process. Through a forward-looking assessment process the HFPM contributes to building resilience within health systems, which also contributes directly to improved emergency preparedness and response.
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The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take
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urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 2030, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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To realize Agenda 2030, aid agencies, private philanthropies, and their partners in the Global South need better data to monitor how official development finance (ODF) dollars advance the Sustainable Development Goals (SDGs) and avoid missing the ma
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rk. In this report, we summarize the results of a novel effort to tag and analyze 2.7 million ODF projects between 2010-2021 using machine learning to understand their contributions to the SDG thematic areas at a goal
and target level. This time frame is instructive: it compares the last six years of the Millennium Development Goals era and the first six years of the new SDG age, from early optimism to later uncertainty about the resilience of the agenda to drive collective commitments amid unanticipated global shocks.
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