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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t
...
reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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The Multi-Hazard Early Warning System (MHEWS) Checklist is a practical tool consisting of major components and actions that national governments, community organizations and partners within
and across all sectors can refer when developing or evalua
...
ting early warning systems
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The document “Pandemic Planning Response Guide” provides guidance for organizations on how to prepare for, respond to, and recover from a pandemic. It explains what a pandemic is and emphasizes the importance of advance planning to reduce disruptions to operations. The guide presents a structure
...
d response framework based on different pandemic phases—from early alert and pre-pandemic preparation to the active pandemic phase and the recovery period afterward. For each phase, it outlines triggers, strategic actions, and practical tasks organizations should implement, such as establishing communication plans, ensuring business continuity, supporting remote work, managing supply chains, and protecting employee health and safety. In addition, the guide discusses key planning considerations like crisis communication, mental health impacts, transportation disruptions, and workforce management. Overall, the document serves as a practical template to help organizations maintain essential services and adapt their operations during a global health emergency.
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The NIAID Pandemic Preparedness Plan describes the strategy of the National Institute of Allergy and Infectious Diseases (NIAID) to strengthen research and development for future pandemic threats. The plan focuses on identifying and studying viruses with the potential to cause epidemics or pandemics
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and developing medical countermeasures such as vaccines, therapeutics and diagnostics. A key concept is the research on “prototype pathogens,” which represent virus families that may cause future outbreaks, allowing scientists to prepare tools and knowledge in advance. The document also outlines the importance of surveillance, epidemiological research, technological innovation, clinical trials and international collaboration to enable a faster and more effective response to emerging infectious diseases. Overall, the plan aims to improve scientific preparedness so that new health threats can be detected earlier and controlled more rapidly.
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While the full extent of Cyclone Ida’s impact is still being assessed, early reports indicate significant damage to infrastructure and livelihoods, with an estimated 3,000km2 of land submerged. Preliminary government reports as of 24 March indicate that more than 58,600 houses have been damaged, i
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ncluding 36,747 totally destroyed, 19,733 partially destroyed and 2,184 flooded. More than 500,000 hectares of crops have been damaged, which is expected to significantly increase food insecurity given that the flooding has coincided with the annual harvest season. More than 3,100 schools have been damaged, along with at least 45 health centres.
Nearly 110,000 people remained displaced in more than 130 accommodation centres – mostly schools and other public buildings – in Sofala (90), Manica (26), Zambezia (10) and Tete (4), where humanitarian needs are acute and both the risk of communicable disease outbreaks and protection risks – particularly for women and girls – are high
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This literature review summarizes the link between psychological well-being and entrepreneurial outcomes for small and medium-size enterprises in fragile, conflict, and violence–affected contexts. It identifies potentially promising, scalable psychosocial training interventions, based on cognitive
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-behavioral therapy approaches, that can be adapted and implemented to improve psychological health at the individual level, that could lead to better business performance at the firm level.
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Recent increases in family planning (FP) use have been reported among women of reproductive age in union (WRAU) in Senegal. However, trends have not been monitored among harder-to-reach groups (including adolescents, unmarried and rural poor women), key to understanding whether FP progress is equita
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ble. We combined data from six Demographic and Health Surveys conducted in Senegal between 1992/93 and 2014. We examined FP trends over time among WRAU and subgroups, and trends in knowledge of FP and intention to use among women with unmet need for FP. Our results show that percent demand satisfied is lower among rural poor women and adolescents than WRAU, although higher among unmarried women. Marked recent increases have been observed in all subgroups, however fewer than 50% of women in need of FP use modern contraception in Senegal. Knowledge of FP has risen steadily among women with unmet need; however, intention to use FP has remained stable at around 40% since 2005 for all groups except unmarried women (75% of whom intend to use). Significant progress in meeting the need for FP has been achieved in Senegal, but more needs to be done particularly to improve acceptability of FP, and to strategically target interventions toward adolescents and rural poor women.
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Now entering its ninth year, the crisis in north-east Nigeria has created vulnerabilities and humanitarian concerns. An estimated 7.7 million men, women, boys and girls are in acute need of protection and assistance. While the humanitarian community
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has provided life-saving assistance to over 5.6 million affected people in 2017 and helped stabilise living conditions for millions of people, reducing mortality and morbidity, significant humanitarian needs still remain.
The Humanitarian Response Plan at a glance:
STRATEGIC OBJECTIVE 1
Provide life-saving emergency assistance to the most vulnerable people in conflict-affected areas ensuring that assistance is timely and appropriate and meets relevant technical standards.
STRATEGIC OBJECTIVE 2
Ensure that all assistance promotes the protection, safety and dignity of affected people, and is provided equitably to women, girls, men and boys.
STRATEGIC OBJECTIVE 3
Foster resilience and early recovery, and strengthen the humanitarian development nexus by working towards collective outcomes.
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This working paper is a case study on South Sudan as an important refugee country of origin. The case study looks at issues of forced displacement in South Sudan and underscores the linkages between internally displaced persons and South Sudanese refugees. The case study highlights the importance of
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understanding local contexts and root drivers of conflict and displacement. It reviews evaluations of programmes in South Sudan, including past efforts at state building and refugee resettlement to look at learning within the international community. The study was undertaken as part of a wider research project on learning from evaluations to improve responses to situations of forced displacement .
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Background Paper prepared for the 2015 Global Assessment Report on Disaster Risk Reduction
The aim of this paper is to help bring voluntary standards into the toolbox of disaster risk reduction, including both by encouraging their use by business and by enhancing their role in legislation and ... regulatory practice.
- Authorities can build awareness for standards in Disaster Risk Reduction (DRR), by facilitating access to relevant standards, encouraging education on DRR-related standards and involving the standardization community.
- Standards need to be sustained by a powerful infrastructure that allows for reliable inspections, audits and precise measurements to be conducted by skilled professionals.
- Risk management best practice needs to embed, as emdodies in standards, more fully in regulatory frameworks in sectors that are relevant. more
The aim of this paper is to help bring voluntary standards into the toolbox of disaster risk reduction, including both by encouraging their use by business and by enhancing their role in legislation and ... regulatory practice.
- Authorities can build awareness for standards in Disaster Risk Reduction (DRR), by facilitating access to relevant standards, encouraging education on DRR-related standards and involving the standardization community.
- Standards need to be sustained by a powerful infrastructure that allows for reliable inspections, audits and precise measurements to be conducted by skilled professionals.
- Risk management best practice needs to embed, as emdodies in standards, more fully in regulatory frameworks in sectors that are relevant. more
This report provides an overview of the latest tuberculosis (TB) epidemiological situation and is published jointly by the WHO Regional Office for Europe and the European Centre for Disease Prevention and Control. In 2023, 38 993 cases of TB were reported in 29 European Union and European Economic A
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rea (EU/ EEA) countries, resulting in a notification rate of 8.6 per 100 000 population in the EU/ EEA. This represented a continuation of the slight increase observed in most countries for 2022, while the overall trend has continued to decrease over the last five years. Exceptions to this trend were Cyprus, Greece, Iceland and Slovakia where an increase of 1−3% was observed in 2023 against data reported for 2019. However, the rates for 2020−2021 should be interpreted with caution, given the measures implemented to mitigate the COVID-19 pandemic and their impact on TB data collection and patient access to health service
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The Central African Republic is at a major turning point in its history. The country
is just emerging from a very violent conflict, during which thousands of human lives were lost and one-third of the population was displaced. After
a three-year transition, and with the support of the internationa
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l community, authorities successfully created the conditions required to conduct credible presidential and legislative
elections. Central African citizens mobilized to express their desire for peace and to break
with the cycle of past violence. Their exemplary democratic maturity ensured the electoral
process was peaceful, despite palpable tensions. The welcome given Pope Francis in Bangui in
November 2015 and visible reconciliation efforts demonstrate the population wishes to turn
the page on this conflict.
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Many African countries were amongst the most rapid to respond to the emerging threat of COVID-19, implementing large-scale interventions at very early stages of their epidemic. As demonstrated in this document using very simple models, this rapid mobilization and timeliness of implementing control m
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easures is likely to be an important determinant of their success. Indeed, as these measures were relaxed, subsequent waves of disease have been observed in many countries including South Africa, Kenya, Tunisia, Morocco, Sudan and the Democratic Republic of Congo (DRC) where such waves have severely impacted the health system by straining the supply of oxygen and ICU beds and inflicting a heavy toll on healthcare workers, often necessitating the re-imposition of control measures.
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Ocean plastic pollution has reached crisis level: every minute, more than an entire garbage truck of plastic makes its way into the world’s oceans—roughly 11 million metric tons annually. While plastic waste presents an immediate threat to marine wildlife and ecosystems, this global challenge al
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so has implications for major industries such as fishing and tourism, impacting the livelihoods of millions of people. The drivers and impacts of ocean plastic pollution also contribute to global challenges in food security, human health, and climate change.
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Surveillance, prevention and control of leishmaniases in the European Union and its neighbouring countries
European Centre for disease prevention and control (ECDC)
European Centre for disease prevention and control (ECDC)
(2022)
C_CDC
This technical report presents the epidemiology of human and animal leishmaniases in the EU and its neighbouring countries and concludes that the disease remains widespread and underreported in many countries of southern Europe, northern Africa, and the Middle East and that there is a need to improv
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e leishmaniasis prevention and control based on robust surveillance in humans, animals, and vectors, and to increase public awareness following a one health approach.
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The Lancet Volume 390, Issue 10110p2397-2409November 25, 2017.
Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to
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sustained and coordinated efforts during the past 15 years the number of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler treatments.
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Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A
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Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
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he United Nations Development Programme’s (UNDP) Gender Equality Strategy 2022-2025 has
been created during turbulent times. Multiple crises and risks are threatening the world and
we are witnessing an alarming backlash against women’s rights and gender equality. Since the
COVID-19 pandemic h
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it, women have been nearly twice as likely to lose their jobs compared to
men. Yet less than 20 percent of policy measures implemented by countries across the world have
addressed women’s economic insecurity. Gender inequality also takes a toll on men and other
affected groups. For men, rigid gender norms can fuel risky behaviours resulting in violence, poor
health, and lower life expectancy.
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Cholera is a diarrhoeal disease that is usually contracted when drinking water contaminated with Vibrio cholerae bacteria. The fight against this disease requires a multidisciplinary approach that combines a water, hygiene and sanitation (WaSH) response with a monitoring system, improved water suppl
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y and quality, sanitation and hygiene, and a health response with the treatment of the disease itself.
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BMJ Global Health2020;5:e002914. doi:10.1136/bmjgh-2020-002914
The evidence produced in mathematical models plays a key role in shaping policy decisions in pandemics. A key question is therefore how well pandemic models relate to their implementation contexts. Drawing on the cases of Ebola and in
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fluenza, we map how sociological and anthropological research contributes in the modelling of pandemics to consider lessons for COVID-19. We show how models detach from their implementation contexts through their connections with global narratives of pandemic response, and how sociological and anthropological research can help to locate models differently. This potentiates multiple models of pandemic response attuned to their emerging situations in an iterative and adaptive science. We propose a more open approach to the modelling of pandemics which envisages the model as an intervention of deliberation in situations of evolving uncertainty. This challenges the ‘business-as-usual’ of evidence-based approaches in global health by accentuating all science, within and beyond pandemics, as ‘emergent’ and ‘adaptive’.
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