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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the
...
patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
more
Severe Acute Malnutrition (SAM) is one of the greatest child survival challenges in the world today and
reportedly affects more than 16.2 million children each year1. High impact, proven treatment interventions exist
yet sadly approximately only 3.2 million children with SAM have access to treatme
...
nt each year2. Thus, there
is a need to scale up interventions to improve coverage and access across high burden countries. While efforts
are currently underway to expand services in many countries, obstacles remain.
One critical barrier to expanding SAM treatment services is the acceptance, accessibility and utilisation of
ready-to-use therapeutic food (RUTF). In some countries and contexts, RUTF is still not fully accepted by
community members; while other countries face problems with procurement, storage and supply chain
management which impact on availability and use3. Reports from Ghana and Zambia highlighted that stock-
outs and logistical challenges are often noted as key contributors to high default rates in outpatient treatment
centres4.
more
Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidly implemented in countries, in the short to medium
...
term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
more
The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by countries and health sys
...
tems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
more
The Guidance on global monitoring for diabetes prevention and control by WHO provides a comprehensive framework to support countries in tracking and managing diabetes prevention, care, and outcomes. This document outlines indicators across 4 domains: health
...
system determinants, service delivery, risk factors, and outcomes/impacts. The guidance helps countries align their monitoring efforts with WHO’s global diabetes targets, Global Diabetes Compact, and relevant global NCD targets.
more
Caring for burns patients from the incident scene to definitive treatment can be a complex, resource-consuming process with the potential to overwhelm health system capacity.This document provides practical guidance for building capacity and capabil
...
ity for burns care from clinical, human resources and operational perspectives. It is therefore recommended that guidance in this document be applied to any contexts in which the local health system might struggle to cope and require surge support.
more
It is estimated that around 2 billion people worldwide do not have access to essential medicines. Access to medicines in the Eastern Mediterranean Region varies among countries, depending on their income level and allocation of domestic resources to medicine and vaccine procurement. Access to safe a
...
nd effective antibiotics remains a major challenge, especially for low- and middleincome countries. Barriers to access include high prices for new products, weak regulatory systems, substandard and falsified antibiotics, shortages of essential antimicrobials and inefficient procurement and supply management systems.
more
In 2023, Breakthrough ACTION and Guyana’s Ministry of Health refined the 'Lil Mosquito, Big Problem' malaria campaign using human-centred design. Phase II introduced peer-led videos (Miners' Buzz), community champions, incentives for volunteer testers and a transport network to improve
...
supply delivery. These efforts enhanced engagement, coordination and timely reporting, reaching over 7,800 people. The campaign's innovative, community-driven approach has improved malaria prevention in remote mining regions.
Accessed on 20/06/2025.
more
These guidelines have been developed in simple, user-friendly language and they explain the procedures for patients’ access to and the safe management of Schedule I and II drugs that are necessary for the treatment and relief of moderate to severe pain. They provide both procedures for acquisition
...
and information on records or documents that are necessary to ensure that these medicines are made available and accessible to patients across the entire health care delivery system (i.e. from tertiary institutions to primary level) and ensuring prevention of illicit non-medical use.
more
he UNFPA “Programmatic guidelines: Cash and Voucher Assistance in Sexual and Reproductive Health programming in Emergencies” explains how CVA can be effectively integrated into humanitarian responses to help women, girls, and other vulnerable groups access lifesaving and comprehensive SRH servic
...
es. Rooted in UNFPA’s mandate, this document provides practical direction for designing, implementing, and monitoring CVA within SRH programming.
The guidance highlights the barriers that hinder access to SRH care, such as affordability, availability, acceptability, and appropriateness, and illustrates how CVA can address financial obstacles by covering transport, user fees, or other indirect costs, while reinforcing health system strengthening efforts. CVA is presented as a complementary tool that supports both emergency and long-term SRH goals. Within humanitarian emergencies, it can contribute directly to achieving MISP objectives, including:
Enabling survivors of sexual violence to access clinical and psychosocial care;
Supporting the continuation of HIV and STI treatment, including coverage of transport;
Facilitating safe deliveries and emergency obstetric and newborn care; and
Removing financial barriers to voluntary family planning and contraceptive access, while ensuring informed choice and avoiding coercion.
Beyond the MISP, CVA also supports the transition to comprehensive SRH services in protracted emergencies and recovery phases. Examples include using cash or vouchers to encourage antenatal and postnatal care, ensure menstrual hygiene, sustain cancer prevention and treatment, fund obstetric fistula repair, and promote SRH education among adolescents.
more
On 4 September 2025, the Ministry of Health of the Democratic Republic of the Congo (DRC) declared an outbreak of Ebola Virus Disease (EVD) in Kasai Province, following confirmation of Zaire ebolavirus by the National Institute of Biomedical Research (INRB) in Bulape and Mweka Health Zones. As of 19
...
September, there have been 48 total cases (38 confirmed, 10 probable) with 31 deaths (21 confirmed, 10 probable) and a CFR of 64.5%. Among laboratory confirmed cases, 16 deaths were recorded (CFR: 45.7%). Four deaths occurred among health workers, underscoring the risk of nosocomial transmission. Most cases (39.7%) are among adults aged 20 years and above, in a densely populated, remote, and under-resourced area.
The outbreak is driven by multiple risk factors, including transmission in health facilities with limited infection prevention and control (IPC) measures and personal protective equipment (PPE), incomplete contact tracing, delayed detection, and unsafe burial practices. High population mobility between Bulape and Tshikapa, reliance on traditional healers, and the concurrent mpox outbreak are further straining the fragile health system and increasing the risk of geographic spread.
more
The document provides a standardized protocol for evaluating the Early Warning Alert and Response Network (EWARN), a surveillance system used during humanitarian emergencies when regular national health surveillance may be disrupted. The purpose of
...
EWARN is to detect outbreaks of communicable diseases early and enable rapid public health response. The guidance explains how the system should be assessed in terms of its structure, implementation, effectiveness, and usefulness. It outlines the key steps of evaluation: preparation, system description, data collection, and post-evaluation reporting. The protocol highlights common challenges observed in previous EWARN implementations, such as delays in establishing the system, limited data quality, weak outbreak response, and lack of clear transition plans back to routine surveillance systems. It emphasizes the need to evaluate both weekly disease reporting and alert verification processes, and to review attributes such as simplicity, data quality, timeliness, sensitivity, and stability. The document also provides templates for interviews, data review forms, and laboratory assessment, as well as guidance on conducting remote evaluations when access is limited. The overall goal of the protocol is to ensure that EWARN functions effectively to detect and respond to outbreaks and that practical recommendations are developed to improve the system’s performance and sustainability in emergency settings.
more
Multi-month dispensing (MMD) is the prescribing and dispensing of three to six months of antiretrovirals
(ARV) and other medicines required for treatment of people living with HIV (PLHIV). This approach is in
contrast to the current standard of care approach where drug dispensing requires monthly
...
clinical visits.
While many programs have moved to providing MMD for adults, implementation in children has been
particularly challenging. MMD takes a client-centered approach and has the promise of improving and
sustaining continuity of treatment and rates of viral suppression (VS), as well as reducing the provider the
provider workload and other burdens on the health system.
more
During fresh fruit and vegetables (FFV) production, water is used for a variety of purposes. Even the water was conventionally treated and disinfected, it may still potentially contain human pathogens, albeit at low concentrations. A risk assessment, appropriate to the national or local production c
...
ontext, should be conducted to assess the potential risks associated with a specific water source or supply in order to devise the appropriate risk mitigation strategies.
Since the 48th session of Codex Committee on Food Hygiene (CCFH) noted the importance of water safety and quality in food production and processing, FAO and WHO has undertaken the work on this subject. This report describes the output of the third in a series of meetings, which examined appropriate and fit-for-purpose microbiological criteria for water used with fresh fruit and vegetables. The advice herein will support decision making when applying the concept of fit-for-purpose water for use in the pre- and post-harvest production of fresh fruit and vegetables.
more
This document, with a focus on the built environment and health care facilities, intends to guide the audience in preparing for and responding to SARI pandemics caused by existing and novel pathogens. It provides technical guidance on designing, establishing, and managing health care facilities for
...
severe acute respiratory infections (SARI), covering point of entry, treatment centers, entry to health system facilities, quarantine and community facilities, and home care and quarantine.
more
HEARTS provides a set of locally adaptable tools for strengthening the
management of CVD in primary health care.
HEARTS is designed to enhance implementation of WHO PEN by providing:
• operational guidance on further integrating CVD management
• technical guidance on evaluating the impact of
...
CVD care on patient outcomes.
For countries not using WHO PEN, CVD management can still be integrated into
primary health care. The process of implementing HEARTS will vary, depending
on country context, and may require a significant reorienting and strengthening
of the health system. At some sites, existing CVD management services may be
reoriented toward a risk-based approach, while other sites may adopt a public
health approach, strengthening management of particular risk factors such as
hypertension. Whether or not introducing CVD management into primary care is a
new intervention, successful implementation will require engagement with national and local health planners, managers, service providers, and other stakeholders.
more
Tanzania: The National Action Plan on AMR 2017-2022
The United Republic of Tanzania - Ministry of Health Community Development Gender Elderly and Children
World Health Organization WHO
(2017)
C_WHO
This National Action Plan addresses actions needed to be taken in order to combat antimicrobial resistance (AMR) in the country. It is obligatory to raise awareness of antimicrobial resistance and promote behavioral change through public communication
programmes that targets human, animal and plant
...
health. Inclusion of the use of antimicrobial agents and resistance in school curricula will further promote better understanding and awareness from an early age. Antimicrobial Resistance knowledge, surveillance and research will be strengthened through establishing a national surveillance system for antimicrobial resistance, establishing and building capacity for a national reference laboratory and designated laboratories for AMR surveillance, developing a national research agenda on AMR and establishing and supporting a coordinated mechanism that will ensure harmonized AMR guidelines, data management and sharing systems in human, animal and plant health settings.
more
In 2007, WHO warned that infectious diseases are emerging and re-emerging at a rate that has not been seen before. The potential for infectious diseases to spread rapidly results in high morbidity and mortality, causing a potential global public health treat of major concern.
Several factors are
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contributing to the (re)emergence of infectious diseases such as population growth, living in close contact with animals, frequent travelling, poverty, destructive ecological changes due to economic development and land use and climate change result in global warming.
Especially Africa is at a threat for (re)emerging infectious diseases due to the huge population growth (expected to reach 2.5 billion by 2050) with rapid urbanisation. Additionally, people across and beyond the continent are excessively mobile which is combined with a weak health system. Moreover, the risk of (re)emerging infectious disease is further heightened by three newly adopted continental initiatives: African Continental Free Trade Area, Free Movement of Persons and African Passport and Single African Air Transport Market.
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For many years, Community Health Care Workers (CHWs) in Tanzania and Africa in general have played significant role in community health promotion. Their specific roles have been changing from time to time. However, their key roles have over time included giving health education and dissemination of
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health information to communities, invariably moving on to include other services such as offering curative services and conducting community surveys. Deployment of CHWs has mainly been a response to the severe shortage of the human resource for health in most African countries due to brain drain for various reasons that include unattractive terms and conditions of employment. On the other hand the human resources for health (HRH) is a result of positive growing demand for health services, a situation confronted by inadequate supply of trained health personnel from training institutions to meet the demand.
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An Indicator-based Approach - This manual presents an indicator-based approach for rapidly assessing pharmaceutical management systems and programs. The manual contains a set of 46 indicators of performance, grouped under eight topics of pharmaceutical management, with each topic being covered by a
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subset of indicators. Thirty-four of the indicators are quantitative, that is, expressed as numbers. Twelve are qualitative, in that they describe the presence or absence of a policy or management system, and in some cases, the degree of implementation.
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