PLoS ONE 18(5): e0285031. https://doi.org/10.1371/journal.pone.0285031
The study aims to integrate HPV vaccination into routine care in adolescent HIV clinics. To achieve success, we will co-design a package of implementation strategies using a previously successful implementation research approach... developed for cervical cancer prevention in LMICs: the Integrative Systems Praxis for Implementation Research (INSPIRE). INSPIRE is a novel, comprehensive approach to develop, implement, and evaluate implementation science efforts
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The “Declaration for Accelerated Malaria Mortality Reduction in Africa” is a statement signed by African health ministers reaffirming their commitment to reducing malaria-related mortality. It pledges strengthened leadership, increased domestic financing for malaria control programs, and the imp...lementation of current technical guidelines. The ministers emphasize the need to invest in data technologies, enhance cross-sector collaboration, and build partnerships for financing, research, and innovation in order to intensify malaria control efforts at both national and subnational levels.
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Zambia has completed the implementation of the National TB Strategic Plan (2017-2021) that set in motion the TB elimination agenda in Zambia through coordinated and accelerated TB response. During this period, the National TB and Leprosy Programme (NTLP) registered tremendous success.
The NTLP is ...poised to attain the ambitious goal pronounced by the government of eliminating TB by 2030, in line with the Sustainable Development Goals (SDGs) and the World Health Organization End TB Strategy. The programme exponentially increased TB notifications from as low as 35,922 people with TB in 2018 to 40,726 in 2020 and in 2021 the TB notifications rose to 50,825 (a 25% increase against 2020 performance). The NTLP also registered incredible success in sustaining high TB Preventive Treatment (TPT) initiations among persons living with HIV and a high TB treatment success rate among drug-susceptible TB cases. New and relapse TB notifications in children below 15 years increased by 43%, from 2,724 in 2020 to 3,890 in 2021. TB notifications ratio between children aged 0-4 and 5-14 was 0.9, an improvement from what we achieved in 2018 (the ratio was 0.7). The proportion of TB patients who are HIV positive continued to decrease, reaching 34% in 2021 from 39% in 2020. Sustained increases in TB notifications, treatment success rate, and TPT initiations have resulted in a rapid decrease in the TB incidence rate that reached 307 per 100,000 population in 2021 against a rate of 391 in 2015.
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This document by Medicines for Malaria Venture (MMV) highlights the significant burden of malaria on children worldwide, emphasizing the need for effective prevention, diagnosis, and treatment strategies. It reviews current challenges and progress in combating pediatric malaria, advocating for conti...nued research and investment to reduce malaria-related morbidity and mortality in children, especially in high-burden regions.
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The African Palliative Care Association is pleased to publish the first edition of Palliative Care Standards for Africa. The development of these standards was achieved through wide consultation with service beneficiaries and providers, and they have been developed to suit different levels of ... service delivery, from primary to tertiary. These standards are underpinned by the World Health Organization’s definition of palliative care, and recognise that scaling up palliative care requires a public health approach with four pillars: policy, education, drug availability and implementation. In addition, the increasing need to establish specific indicators of quality and effectiveness for palliative care has been a big driving force behind these comprehensive standards. It is APCA’s wish that they will provide a framework for the development of evaluation
and performance indicators that can facilitate programme improvement and development. The standards are designed to allow the development or improvement of palliative care across the different services levels, within the organisational capacity of various service providers. They describe a relationship between primary, intermediary and tertiary level service providers, with expectations for all providers articulated through detailed criteria for each standard. It is therefore expected that these standards will influence the planning and delivery of palliative care services at all levels of health care service delivery.
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Updated guidance on the integration of diabetes, hypertension and mental health services, and interventions to support adherence to antiretroviral therapy. The guideline offers practical implementation guidance for countries and key stakeholders as well as outlining key research gaps. As life expec...tancy for people living with HIV continues to increase, managing noncommunicable diseases, mental health, and adherence to antiretroviral therapy is essential to sustaining treatment success, quality of life, and engagement in care. A life course approach addresses these needs from childhood through older age. Service integration supports more person-centred, coordinated care across the life course.
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Access to safe, effective and quality-assured health products and technologies is crucial for achieving universal health coverage and primary health care goals. The continued growth of the aging population; increasing burden of noncommunicable diseases; growing burden of mental health issues; climat...e change; shifting patterns of vector borne diseases, fungal disease and waterborne diseases; antimicrobial resistance; and new infectious hazards create an ongoing need for equitable access to safe, effective and quality-assured health products and technologies, and renewed investments in research and development for innovative health products and technologies.
The coronavirus pandemic exposed the inequalities in access to health products, highlighting the need for longer-term strategies to strengthen access to health products and technologies outside of and in emergency situations. While technological and scientific advances present an opportunity to increase access to health products and technologies, the risk of increasing inequality due to higher prices for new health products and technologies; the persisting problem of substandard and falsified medical products; a lack of skilled workforce in many low- and middle-income countries; and a lack of data for decisionmaking and for measuring progress present significant challenges.
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4th edition
The WHO Laboratory Biosafety Manual (LBM) has been in broad use at all levels of clinical and public health laboratories, and other biomedical sectors globally, serving as a de facto global standard that presents best practices and sets trends in biosafety.
LBM encouraged countries t...o accept and implement basic concepts in biological safety and to develop national codes of practice for the safe handling of biological agents in laboratories within their geographical borders.
This fourth edition of the manual builds on the risk assessment framework introduced in the third edition. A thorough, evidence-based and transparent assessment of the risks allows safety measures to be balanced with the actual risk of working with biological agents on a case-by-case basis.
This novel evidence- and risk-based approach will allow optimised resource use and sustainable laboratory biosafety and biosecurity policies and practices that are relevant to their individual circumstances and priorities, enabling equitable access to clinical and public health laboratory tests and biomedical research opportunities without compromising safety.
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This report presents the findings of the Estimating the Size of Populations through a Household Survey (ESPHS) study that took place in 2011. The study utilized a single household survey to estimate the size of several key populations, including sex workers, men who have sex with men (MSM), injectin...g drug users (IDU), and clients of sex workers. These populations include several groups outlined in the National Strategic Plan for HIV and AIDS as most at risk for HIV infection, specifically sex workers and MSM.
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9 June 2021
Since its launch, GLASS has expanded in scope and coverage and as of May 2021, 109 countries and territories worldwide have enrolled in GLASS. A key new component in GLASS is the inclusion of antimicrobial consumption (AMC) surveillance at the national level highlighted in this fourth G...LASS report.
The fourth GLASS report summarizes the 2019 data reported to WHO in 2020. It includes data on AMC surveillance from 15 countries and AMR data on 3 106 602 laboratory-confirmed infections reported by 24 803 surveillance sites in 70 countries, compared to the 507 923 infections and 729 surveillance sites reporting to the first data call in 2017.
The report also describes developments over the past years of GLASS and other AMR surveillance programmes led by WHO, including resistance to anti-human immunodeficiency virus and anti-tuberculosis medicines, antimalarial drug efficacy.
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The Practical manual on laboratory strengthening, 2022 update provides practical guidance on implementation of WHO recommendations and best practices for TB laboratory strengthening. It is an updated version of the GLI Practical Guide to Laboratory Strengthening published in 2017 and provides the la...test practical guidance on use of newly recommended diagnostics as well as guidance in key technical areas, including quality assurance and quality management systems, specimen collection and registration, procurement and supply-chain management, diagnostic connectivity, biosafety, data management, human resources, strategic planning, and model algorithms. The key changes are:
inclusion of recent or updated WHO recommendations for tests to diagnose TB and detect drug resistance;
alignment with the latest WHO critical concentrations for phenotypic drug-susceptibility testing (DST) and the new definitions of pre-XDR-TB and XDR-TB;
updated information on building quality-assured TB testing and management capacity using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach (Score-TB package1);
updated information on assessing, analysing and optimising TB diagnostic networks; and
updated information on the use of next-generation sequencing (NGS) to detect mutations associated with drug resistance for surveillance purposes.
The document also provides references to resources and tools relevant for work on laboratory strengthening.
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Review of International, Regional and National Policies and Legal Frameworks that Promote Migrants and Mobile Populations' Access to Health and Malaria Services in the Greater Mekong Subregion (Cambodia, Lao People's Democratic Republic, Myanmar, Thailand and Viet Nam)
Migrants and mobile popul...ations face many obstacles in accessing equitable essential health care services due to factors such as living and working conditions, education level, gender, irregular migration status, language and cultural barriers, anti-migrant sentiments, and lack of migrant-inclusive health policies among others. Despite significant progress having been made in the context of malaria control in the Greater Mekong Subregion (GMS), human movements can impact malaria transmission patterns and potentially introduce drug-resistant parasites. This legal framework review therefore serves as a guidance document on approaches to address malaria and malaria elimination for migrant and mobile populations (MMPs) in five countries of the GMS.
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Improvements in water sanitation and hygiene (WASH) and wastewater management in all sectors are critical elements of preventing infections and reducing the spread of antimicrobial resistance (AMR) as identified in the Global Action Plan to combat AMR. Yet, at present, WASH and wastewater management... actors and improvement actions are under-represented in AMR multi-stakeholder platforms and national action plans (NAPs). This WHO/FAO/OIE technical brief on WASH and wastewater management to reduce the spread of AMR provides a summary of evidence and rationale for WASH and wastewater actions within AMR NAPs and sector specific policy to combat AMR. Evidence and actions are presented in the domains of; coordination and leadership, households and communities, health care facilities, animal and plant production, manufacturing of antimicrobials, and surveillance and research.
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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.
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Antibiotics have been a critical public health tool since the discovery of Penicillin in 1928, saving the lives of millions of people around the world. In developing country like ours, where the burden of treatable disease is very high and access to health facilities and laboratories is difficult, a...ntibiotics have long acted as miracle drugs. Today, however, the emergence of drug
resistance in bacteria is reversing the miracles of the past eighty years, with drug choices for the treatment of many bacterial infections becoming increasingly limited, expensive, and in some cases, nonexistent. Diseases previously regarded as relatively easy to manage are much harder to treat as doctors must use “last-resort” drugs that are more costly, take longer to work
and are often unavailable or unaffordable in developing countries. Moreover, regular prescription of antibiotics, random treatment, over the counter sales, inadequate dosage, inclusion of antibiotics in animal feeds and agriculture has contributed equally to emergence of antibiotics resistance as silent epidemic within the country.
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This policy brief has been developed in response to the contemporary challenge of antibiotic resistance (ABR). ABR poses a formidable threat to global health and sustainable development. It is now increasingly recognized that the systematic neglect of cultural factors is one of the biggest obs...tacles to achieving better health outcomes and better standards of living worldwide. Using a cultural contexts of health approach, the policy brief explores the centrality of culture to the challenge of ABR. The brief examines how the prescription and use of antibacterial medicines, the transmission of resistance, and the regulation and funding of research are influenced by cultural, social and commercial, as well as biological and technological factors. The brief moves beyond the ready equation of culture with individual behaviours and demonstrates how culture serve as an enabler of health and provide new possibilities for change.
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This report provides an update on the key facets of HIV treatment access, including the latest HIV treatment guidelines from World Health Organization (WHO), an overview on pricing for first-line, second-line, and salvage regimens, and a summary of the opportunities for – and threats to – expand...ing access to affordable antiretroviral therapy (ART).
The report is supplemented by 11 drug profiles that contain more detailed information on pricing trends and patent barriers for key antiretroviral drugs and fixed-dose combinations. Also included is an annex of conditions that define eligibility for reduced prices from 15 pharmaceutical companies.
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Since 1996, trachoma has been targeted for elimination as a public health problem worldwide. The active trachoma criterion for national elimination as a public health problem is a TF1–9 < 5%, sustained for at least two years in the absence of antibiotic mass drug administration (MDA), in each form...erly endemic EU. Using A, F and E, health ministries and their partners have made considerable progress towards achieving this criterion in formerly endemic EUs worldwide. In 2002, an estimated 1517 million people lived in EUs in which EU-wide implementation of the A, F and E components of SAFE were thought to be needed for the purposes of global elimination of trachoma as a public health problem; by June 2021, that number had fallen to 136.2 million, a 91% reduction. Approximately 85% of the 136.2 million people living in EUs needing A, F and E in June 2021 were in WHO’s African Region.
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Co-trimoxazole is a fixed-dose combination of two antimicrobial drugs (sulfamethoxazole and trimethoprim) that covers a variety of bacterial, fungal and protozoan infections. Co-trimoxazole preventive therapy is a feasible, well tolerated and inexpensive intervention for people living with HIV to re...duce HIV-related morbidity and mortality. Further, co-trimoxazole is an off-patent drug and widely available in resource-limited settings.
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This document provides guidance on how to implement contact screening and chemoprophylaxis with single-dose rifampicin. The contents are logically ordered: counselling and obtaining consent, identification and listing of index case, listing of contacts, tracing of contacts, screening of contacts, ad...ministration of prophylactic drugs. Managerial aspects to undertake contact screeninig and chemoprophylaxis are also elaborated, including planning , training , supervision and drug management.
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