Bioethics 519 (online) doi:10.1111/bioe.12145 Volume 29 Number 8 2015 pp. 488–596;
Pandemic plans recommend phases of response to an emergent infectious disease (EID) outbreak, and are primarily aimed at preventing and mitigating human-to-human transmission. These plans carry presumptive weight ...and are increasingly being operationalized at the national, regional and international level with the support of the World Health Organization (WHO). The conventional focus of pandemic preparedness for EIDs of zoonotic origin has been on public health and human welfare. However, thisfocus on human populations has resulted in strategically important disciplinary silos. As the risks of zoonotic diseases have implications that reach across many domains outside traditional public health, including anthropological, environmental, and veterinary fora, a more inclusive ecological perspective is paramount for an effective response to future outbreaks.
more
This document sets out, therefore, to explain the socioeconomic value of investing in the fight against NTDs and highlights priorities for global investment attention. Our work was guided by the need not only for
additional funding and funders but also for the need to understand the current funding... climate, in which value for money and the efficient use of resources to fill the most critical of gaps are more relevant than ever.
more
Advances have been made through expanded interventions delivered through five public health approaches: innovative and intensified disease management; preventive chemotherapy; vector ecology and management; veterinary public health services; and the provision of safe water, sanitation and hygiene. I...n 2015 alone nearly one billion people were treated for at least one disease and significant gains were achieved in relieving the symptoms and consequences of diseases for which effective tools are scarce; important reductions were achieved in the number of new cases of sleeping sickness, of visceral leishmaniasis in South-East Asia and also of Buruli ulcer.
The report also considers vector control strategies and discusses the importance of the draft WHO Global Vector Control Response 2017–2030.
more
The guidelines acknowledge that overcrowding, unhygienic conditions and high inmate turn over contribute to the spread of infectious diseases within correctional facilities. The document states that voluntary HIV counselling and testing must be offered to all inmates when they enter facilities, duri...ng their incarceration at an inmate’s request and upon their release. All inmates must be screened for TB symptoms upon entry to facilities and at least bi-annually thereafter as well as upon release. Universal screening for anal, oral and genital STIs must be done at entry and upon self-presentation
more
The primary audience for this guidance is persons
working directly in vector-borne disease prevention
and control, including programme managers,
researchers and field workers. A brief technical
background is provided for the benefit of persons
without expertise in vector-borne diseases; readers...
working in the field may wish to skip the background
section and begin with the discussion of ethical
issues and values in Chapter 3. The guidance cannot
offer universally applicable answers to the complex
ethical issues raised, nor can it provide a checklist of
issues that are necessarily relevant in all situations.
Rather, its goal is to help readers recognize aspects
of their work that raise significant ethical challenges
and to respond to these challenges in accordance
with internationally accepted values and norms.
more
The HEARTS technical package provides a strategic approach to improving cardiovascular health in countries. It comprises six modules and an implementation guide. This package supports Ministries of Health to strengthen CVD management in primary health care settings. The practical, step-by step modul...es are supported by an overarching technical document that provides a rationale and framework for this integrated approach to the management of NCDs.
more
The global increase of healthcare-associated infections (HAI) presents a growing concern in healthcare worldwide. According to the European Centre for Disease Prevention and Control (ECDC), the annual number of HAI exceeds 2.6million and produces the highest estimated amou...nt of disability-adjust-ed-life-years, surpassing all other reported communicable diseases in the European Union and European Economic Area. Multi-drug-resistant Gram-negative (MDR-GN) bacteria have become increasingly common as a cause for HAI, such as central line-as-sociated bloodstream infections, wound or surgical site infections and catheter-associated urinary tract infections
more
The World Health Organization was requested by Member States to develop a global priority pathogens list (global PPL) of antibiotic-resistant bacteria to help in prioritizing the research and development (R&D) of new and effective antibiotic treatments. To date, the selection of pathogens for R&D ac...tivities has been largely guided by small and large pharmaceutical companies according to a variety of parameters, such as perceived/unmet medical need, pressure of investors, market size, scientific discovery potential, and availability of specific technologies. Previous PPLs, issued by the Centers for Disease Control and Prevention.
more
Maldives has made significant strides in the area of infectious disease prevention and control. This is exemplified by elimination of malaria from Maldives in 2015 and successes in TB control. In addition, Maldives is a front runner in infectious disease prevention through successful water, sanitati...on, hygiene and vaccination campaigns and coverage. However, given the limited evidence that exists with respect to the occurrence of resistant organisms in the nation, it is hard to estimate the exact antimicrobial resistance (AMR) scenario. Also, it becomes difficult to compare the current situation with other countries in the region. Moreover, limited evidence exists on the trends of use of antimicrobial agents (AMA) in Maldives. Although, recent prescription audits have indicated overuse of antibiotics, especially for common conditions such as flu, cough and fever.
more
Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.... Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
more
This report reviews and analyses the Affordable Medicines Programme, which was introduced in Ukraine in April 2017 to provide patients with improved access to 23 outpatient medicines for the treatment of chronic noncommunicable diseases. The evaluation combines both quantitative and qualitative anal...ysis. The findings confirm that the Programme has contributed to a significant increase in access to needed outpatient medicines in Ukraine. Further, while implementation was successful overall, uptake across regions was uneven. The report concludes by listing a number of policy options to support the sustainability and expansion of the Affordable Medicines Programme.
more
PlosOne https://doi.org/10.1371/journal.pone.0165797; Food production is a major driver of greenhouse gas (GHG) emissions, water and land use, and dietary risk factors are contributors to non-communicable diseases. Shifts in dietary patterns can therefore potentially provide benefits for both the en...vironment and health. However, there is uncertainty about the magnitude of these impacts, and the dietary changes necessary to achieve them.
more
Development assistance for health (DAH)
plays a vital role in supporting health programmes in lowand middle-income countries. While DAH has historically
focused on infectious diseases and maternal and child
health, there is a lack of comprehensive analysis of DAH
trends, strategic shifts and the...ir impact on health systems
and outcomes. This study aims to provide a comprehensive
review of DAH from 1990 to 2022, examining its evolution
and funding allocation shifts.
more
Screening programmes for tuberculosis (TB) among immigrants rarely consider the heterogeneity of
risk related to migrants’ country of origin. We assess the performance of a large screening programme in asylum seekers by analysing (i) the difference in yield and numbers needed to screen (NNS) by c...ountry and WHO-reported TB burden, (ii) the possible impact of screening thresholds on sensitivity, and (iii) the value of WHO-estimated TB burden to improve the prediction accuracy of screening yield.
more
Cervical cancer is the second most common cancer among women worldwide and causes a significant number of deaths in the South-East Asia Region. Nearly 200 000 new cases of cervical cancer occurred in SEA Region Member States in 2008, giving an incidence of almost 25 per 100... 000 and a mortality rate of almost 14 per 100 000. Cervical cancer can be prevented by early screening and vaccination. However, due to poor access to screening and treatment services, the vast majority of these deaths occur in women from nine Member States of the South-East Asia Region which account for more than one third of the global burden of cervical cancer.
more
INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
more
In the Region of the Americas, the leishmaniases are a group of diseases caused by various species of Leishmania, which cause a set of clinical syndromes in infected humans that can involve the skin, mucosa, and visceral organs. The spectrum of clinical disease is varied and depends on the interacti...on of several factors related to the parasite, the vector, and the host. Cutaneous leishmaniasis is the form most frequently reported in the Region and nearly 90% of cases present single or multiple localized lesions. Other cutaneous clinical forms, such as disseminated and diffuse cutaneous leishmaniasis, are more difficult to treat and relapses are common. The mucosal form is serious because it can cause disfigurement and severe disability if not diagnosed and treated early on. Visceral leishmaniasis is the most severe form, as it can cause death in up to 90% of untreated people.
more
Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
more
People with underlying noncommunicable diseases (NCDs) such as hypertension, diabetes, cardiovascular disease, chronic respiratory disease and cancer have a high risk for developing severe and even fatal COVID-19. It is important for them to strictly follow basic protective measures and make sure th...eir chronic diseases are well managed. However, pandemics cripple health systems and compromise provision routine medical care. This technical note gives general guidance to people living with NCDs, their caregivers and family members, the public, health programme managers and health-care workers on how to reduce risks of a COVID-19 infection and maintain care for people living with NCDs during the outbreak.
more
This toolkit is a "how to" guide for developing, implementing and evaluating a multisectoral action plan for prevention and control of NCDs. It is targeted at policy-makers, planners and programme managers, and is intended to help countries, provinces and cities meet the requirements for achieving g...lobal and national NCD targets and the Sustainable Development Goals. The toolkit takes the user through a series of actions related to the development of a multisectoral action plan ("MSAP development actions"), and provides forms and a template framework for users to complete as they undertake these actions. Developing a multisectoral action plan involves establishing health needs and engaging relevant stakeholders before determining the actions to take, identifying and prioritizing interventions, deciding on ways to address NCDs while establishing support and resources for prevention and control, and evaluating progress in implementing the plan.
more