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1
Publication Years
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Toolboxes
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2
Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing.
This updated cross-sectional study used the same methods as the International study of Asthma and Allergies in Chi
...
ldhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993–95), ISAAC Phase III (2001–03), or both. We included individuals from two age groups (children aged 6–7 years and adolescents aged 13–14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders.
Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993–2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (–0·37, 95% CI –0·69 to –0·04) and an increase in ever having asthma (1·25, 0·67 to 1·83) and night cough (4·25, 3·06 to 5·44), which was also found in children (3·21, 1·80 to 4·62). The prevalence of current wheeze decreased in low-income countries (–1·37, –2·47 to –0·27], in children and –1·67, –2·70 to –0·64, in adolescents) and increased in lower-middle-income countries (1·99, 0·33 to 3·66, in children and 1·69, 0·13 to 3·25, in adolescents), but it was stable in upper-middle-income and high-income countries.
Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden
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ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure on Africa’s already fragile health systems as ODA
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is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at
risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have
consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health.
In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to
213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals
per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more
Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance.
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Regulation and Management of International Emergency Medical Teams
Ville de Goyet, Claude de; Perez Calderon, Luis Jorge; Saimiento, Juan Pablo et al.
International Federation of Red Cross and Red Crescent Societies (IFRC), World Health Organization (WHO)
(2017)
C_WHO
The purpose of this report is to provide an overview of the issues in regulating and managing international emergency in a selection of large and small-scale sudden onset disasters (SODs). In doing so, it aims to contribute to several key international commitments as well as its objective in disaste
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rs and emergencies to “reduce the consequences the event may have on world health and its social and economic implications”.
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Das Management von Krisen hat in den letzten Jahren erheblich an Bedeutung gewonnen, insbesondere auch im Öffentlichen Gesundheitsdienst (ÖGD). Grundsätzlich liegt die Entscheidungshoheit im Rahmen des Krisenmanagements infektiologischer Gefahrenlagen bei den kommunalen Gesundheitsämtern. Aufgru
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nd der aktuellen Lage (Stand 18. März 2020) in Zusammenhang mit der Verbreitung des neuen Coronavirus stellen wir hiermit in einer Vorabversion Auszüge unseres Lehrbuchs zur Verfügung.
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This technical briefing paper details the construction and setup of medical isolation facilities in support of infectious disease outbreak responses.
The safety of children is a top concern for parents and school authorities in the current mpox outbreak, as those
under 15 face elevated risks, particularly in the hardesthit Northwestern and Eastern regions of the Democratic Republic of the Congo.
Early warning systems are an essential tool for risk management and disaster preparedness that help save lives and minimize the potential impact of disasters. To be effective, early warning systems need to rely on the direct participation of at-risk communities, facilitate public education and aware
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ness of risks, disseminate messages and warnings efficiently, and help maintain a constant state of preparedness to enable early action.
Accessed August 2025
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This guide aims to provide an overview of successful practice from the field for the disaster risk reduction/management practitioner interested in EWS. It presents guiding principles that will build a strong foundation for the design or strengthening of EWS at any level. It is not an operational, bu
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t a strategic, guide that insists on asking the right questions and exploring all perspectives prior even to deciding whether or not early warning is the appropriate tool for a given context.
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This channel offers learning resources for strategic health operations, including Ebola and Marburg diseases screening and treatment center design, ultra-low temperature vaccine management and WHO Mobile Very Small Aperture Terminal installation.
Logical Framework Planning Matrix
Armenian Red Cross Disaster Management ProgrammeDisaster Preparedness and Response Project
IFRC - International Federation of Red Cross Red Cresent Societies
(2000)
C1
Matrix
Crisis Emergency Risk Communication. Manual
recommended
The CERC manual provides an evidence-based framework and recommended practices for anyone who communicates on behalf of an organization responding to major emergencies such as natural disasters.
Global Animal Disease Information System - interactive Platform
Open WHO Channels
recommended
Search for relevant channels for outbreak management, pandemic prevention, infectious diseases managment
Through the Emergency Prevention System (EMPRES), FAO assists countries to prevent and control the world’s most serious livestock and zoonotic diseases, while also surveying for newly emerging pathogens. Member countries are supported with early warning, and technical guidance for risk management
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of transboundary threats to the food chain at regional and country levels.
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The future is inherently uncertain, and while we hope to avoid another pandemic, hope alone is not a strategy. To ensure we are better prepared, it is important to proactively explore plausible futures through structured foresight exercises.
The Country COVID-19 Intra-Action Review (IAR) is a facilitated process that brings together COVID-19 responders from multiple sectors for experience sharing and collective learning, and it has been modelled after the WHO After Action Review (AAR) methodology.
This channel is an introduction to simulation exercises and their value as part of wider emergency preparedness to raise awareness among a non-technical audience.
This resource offers practical guidance in managing the supply chain, with emphasis on health comodities. The handbook is particularly useful for program managers who design, manage, and assess logistics system for health program. The document includes detailed information about the design and imple
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mentation of logistics management information systems and inventory control systems. It also covers quantification, procurement processes, as well as storage, transport and product selection
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