The Strategic Advisory Group of Experts (SAGE) on Immunization held a meeting on 3-6 October 2022. This report summarizes the discussions, conclusions and recommendations.
It covers the following items:
Global Reports
Immunization Agenda 2030 and Regional reports
Monkeypox
RSV
COVID-19 vacci...nes
Polio vaccination
Ebola (Sudan ebolavirus outbreak update)
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This report presents, for the first time, a global assessment of the extent to which health care facilities provide essential water, sanitation and hygiene (WASH) services. Drawing on data from 54 low- and middle-income countries, the report concludes that 38% lack access to even rudimentary levels ...of water, 19% lack sanitation and 35% do not have water and soap for handwashing. When a higher level of service is factored in, the situation deteriorates significantly. A number of areas require urgent action and WHO will work with UNICEF, Governments and other partners to develop a global plan to address the most pressing needs and ensure that all health care facilities have WASH services.
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Shaping Health programme on Learning from international experience on approaches to community power, participation and decision-making in health,AMHF, TARSC
published in: Viruses 2016, 8, 161
Zambia has about 1.2 physicians, nurses, and midwives per 1000 population while the minimum acceptable density threshold is 2.3 per 1000 population. The estimated shortage of doctors, nurses and midwives in Zambia is about 14,960. However, with the projected population growth the deficit more than d...oubles disproportionately to, 25,849 in 2020, and 46,549 in 2035, at the current rate of HRH production. Worryingly, the human resources for health crisis has persisted for over 20 years. The efforts before and leading up to the development and implementation of the 2013 – 2016 National Training Operational Plan (NTOP) and the National Human Resources for Health Strategic Plan (2011 – 2016) yielded certain achievements, however, the HRH numbers and skill-mix gap remained disturbingly enormous.
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his Inter Action Review report for the COVID-19 outbreak in Mauritius documents and assesses the country’s capacity to respond to the outbreak and identifies the best practices, strengths, gaps and challenges of the national response. Areas requiring improvements or sustained actions have been ide...ntified across the 9 strategic pillars of World Health Organization (WHO)’s COVID-19 Strategic Preparedness and Response Plan and an additional pillar for the country’s response beyond health. On an overall, the review aims to enhance and sustain the national response with a particular focus on strengthening the health systems.
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DHS Analytical Studies No. 41
Preliminary overview of refugees and migrants self-reported impact of COVID-19
The study surveyed over 30,000 refugees and migrants living in 170 countries. Many of the respondents had fled war or dire economic conditions in their home country only to be faced with the additional challenges posed b...y COVID-19. Travel restrictions including border closures, suspension of resettlement travel, and last-minute deportation left many stranded or forced to stay in cramped, makeshift shelters or detention centers. Amid these uncertain, precarious conditions, many migrants described either a lack of access to health services or a fear of seeking them out — even if they were experiencing COVID-19 symptoms.
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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Kenya Quality Model for Health - Hospitals
The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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Mpox is an emerging zoonotic disease caused by the mpox virus, a member of the Orthopoxvirus genus closely related to the variola virus that causes smallpox. Mpox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research. The first human case was recorde...d in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox and since then the infection has been reported in a number of African countries. Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels, and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA. Two separate clades of the mpox virus are currently circulating in Africa: Clade I, which includes subclades Ia and Ib, and Clade II, comprising subclades IIa and IIb. Clade Ia and Clade Ib have been associated with ongoing human-to-human transmission and are presently responsible for outbreaks in the Democratic Republic of the Congo (DRC), while Clade Ib is also contributing to outbreaks in Burundi and other countries.
In 2022‒2023 mpox caused a global outbreak in over 110 countries, most of which had no previous history of the disease, primarily driven by human-to-human transmission of clade II through sexual contact. In just over a year, over 90,000 cases and 150 deaths were reported to the WHO. For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent. On 13 Aug 2024, Africa CDC declared the ongoing mpox outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017.7 This declaration empowered the Africa CDC to lead and coordinate responses to the mpox outbreak across affected African countries. On August 14, 2024, the WHO declared the resurgence of mpox a Public Health Emergency of International Concern (PHEIC) emphasizing the need for coordinated international response.
As of August 2024, Mpox has expanded beyond its traditional endemic regions, with new cases reported in countries including Sweden, Thailand, the Philippines, and Pakistan. Sweden has confirmed its first case of Clade 1 variant, which has been rapidly spreading in Africa, particularly in DRC. The emergence of this new variant raises concerns about its potential for higher lethality and transmission rates outside Africa.
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A booklet on how CHWs were addressing eye health across Africa based on desk research and a survey in 23 countries
Antimicrobials are medicines, including antibiotics, antivirals, antifungals, and antiparasitics, that are used to prevent and treat infections in humans, animals, and plants. Antimicrobial Resistance (AMR) arises when bacteria, viruses, fungi, and parasites no longer respond to these medicines, ren...dering them ineffective and making infections more difficult to treat. This resistance increases the risk of disease spread, severe illness, disability, and death. Although AMR is a natural phenomenon driven by genetic
changes in pathogens, it is significantly accelerated by human activities such as the misuse and overuse of antimicrobials in healthcare, agriculture, and animal husbandry.
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The ASEAN Mental Health Systems Report
catalogues the situation of mental health in ASEAN
Member States. This report provides comprehensive
information on the progress made so far by AMS in
integrating mental health into national health systems,
increasing access to care as well as challenges f...aced.
It also offers recommendations on how to improve the mental health system in
respective ASEAN Member States.
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This paper focuses on the Sustainable Development Goals related to poverty, economic growth, inequality, health, food production and the environment. It presents concrete examples of the underlying and complex aspects of antibiotic resistance and its impacts across different Sustainable Development ...Goals. The aim of this paper is to inform and stimulate discussions on how to further advance the implementation of 2030 Agenda for Sustainable Development, the Global Action Plan on Antimicrobial Resistance, National Action plans on Antimicrobial Resistance, as well as work within all sectors that affect and are affected by antibiotic resistance
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