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Objective: To review the effectiveness of antibiotic stewardship interventions in hospitals in low- and middle-income countries.
dades infecciosas. Los antimicrobianos eficaces son imprescindibles para las medidas preventivas y curativas, para proteger a los pacientes frente a enfermedades potencialmente mortales y para garantizar que se puedan llevar a cabo procedimientos complejos, como la cirugía y la quimioterapia, con e
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scasos riesgos. Sin embargo, el mal uso y el abuso sistemático de estos fármacos en la medicina y la producción de alimentos han puesto en riesgo a todas las naciones. Hay pocos productos de recambio en fase de investigación y desarrollo. Sin medidas armonizadas e inmediatas a escala mundial avanzamos hacia una era posantibiótica en la que infecciones comunes podrían volver a ser mortales.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc
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e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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Infectious diseases continue to impose unpredictable burdens on global health and economies, a subject that requires constant research and updates. In this sense, the objective of the present article was to review studies on the role of wild animals as reservoirs and/or dispersers of etiological age
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nts of human infectious diseases in order to compile data on the main wild animals and etiological agents involved in zoonotic outbreaks.
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Clinical Microbiology and Infection Volume 21, Issue 5, May 2015, Pages 433-443;
The neglected zoonotic diseases (NZDs) have been all but eradicated in wealthier countries, but remain major causes of ill-health and mortality across Africa, Asia, and Latin America. This neglect is, in part, a conse
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quence of under-reporting, resulting in an underestimation of their global burden that downgrades their relevance to policy-makers and funding agencies. Increasing awareness about the causes of NZDs and how they can be prevented could reduce the incidence of many endemic zoonoses.
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This booklet presents key messages for action, summarized from a set of chapters on different environmental health issues, available at www.who.int/ ceh/publications/healthyenvironmentsforhealthychildren. The work is a result of an on-going partnership between WHO, UNEP and UNICEF in the area of chi
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ldren’s environmental health, and seeks to update the 2002 joint publication “Children in the New Millennium: Environmental Impact on Health.”
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2020 Symposium Report
Current evidence that the climate is changing is overwhelming. Impacts of climate change and variability are being observed: more intense heat-waves, fires and floods; and increased prevalence of food- water- and vector-borne diseases. Climate change will put pressure on environmental and health det
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erminants, such as food safety, air pollution and water quantity and quality. A climate-resilient future depends fundamentally on reducing greenhouse gas emissions. Limiting warming to below 2 °C requires transformational technological, institutional, political and behavioural changes: the foundations for this are laid out in the Paris Agreement of December 2015. The health sector can lead by example, shifting to environmentally friendly practices and minimizing its carbon emissions. A climate-resilient future will increasingly depend on managing and reducing climate change risks to protect health. In the near term, this can be enhanced by including climate change in national health programming and creating climate-resilient health systems.
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BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3086
Using infectious diseases sensitive to climate as indicators of climate change helps stimulate and inform public health responses
his sequel to the Groundswell report includes projections and analysis of internal climate migration for three new regions: East Asia and the Pacific, North Africa, and Eastern Europe and Central Asia. Qualitative analyses of climate-related mobility in countries of the Mashreq and in Small Island D
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eveloping States (SIDS) are also provided. This new report builds on the scenario-based modeling approach of the previous Groundswell report from 2018, which covered Sub-Saharan Africa, South Asia, and Latin America. The two reports’ combined findings provide, for the first time, a global picture of the potential scale of internal climate migration across the six regions, allowing for a better understanding of how slow-onset climate change impacts, population dynamics, and development contexts shape mobility trends.
Available in English, French, Arabic, Spanish
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The World Climate and Security Report 2021
Brock, S.; Barrett, O.L.; Birkman, L.; et al.
International Military Council on Climate and Security
(2021)
CC
The World Climate and Security Report (WCSR) 2021 from the Expert Group of the International
Military Council on Climate and Security is a global assessment of the security dimensions of a changing
climate and effective means to address them. It is intended to inform timely climate and security po
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licy
and action, and builds upon the analysis in the first WCSR, released in February 2020.
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Road safety is an issue that does not receive anywhere near the attention it deserves – and it really is one
of our great opportunities to save lives around the world
The World Climate and Security Report 2021_2
Brock, S.; Barrett, O.L.; Birkman, L.; et al.
International Military Council on Climate and Security
(2021)
C1
The World Climate and Security Report (WCSR) 2021 from the Expert Group of the International Military Council on Climate and Security is a global assessment of the security dimensions of a changing climate and effective means to address them. It is intended to inform timely climate and security poli
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cy and action, and builds upon the analysis in the first WCSR, released in February 2020.
more
This brief summarizes the lessons learned across Europe on the redevelopment of contaminated sites as a part of urban planning and renewal. Specifically, it aims to provide information on the health and environmental impacts to be considered during site redevelopment projects, and to identify good p
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ractice and relevant local experiences to support effective, healthy and sustainable redevelopment of contaminated sites. As such, this brief offers key messages to support the work of local decision-makers, planners, practitioners, researchers and civil society organizations.
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This document offers public health guidance for the prevention and control of COVID-19 in reception centres, and other temporary accommodation facilities, in the context of the mass influx of Ukrainian people into the European Union (EU), the European Economic Area (EEA) and the Republic of Moldova.
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