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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
...
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.
more
The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the
...
disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
more
In contrast to bilateral aid, aid disbursed from
multilateral institutions increased significantly at the onset
of the COVID-19 pandemic. Yet, at a time when a coherent
and effective multilateral response is needed most, the
COVID-19 pandemic revealed a shifting landscape of donor
agencies that
...
struggle with basic functions, such as crossnational coordination. While multilaterals are uniquely
positioned to transcend national priorities and respond
to pandemics, functionally we find official development
assistance (ODA) from these entities may increasingly
mimic the attributes of bilateral aid. We explore three
important, but not comprehensive, attributes of aid leading
up to and during the COVID-19 pandemic: (1) earmarking,
(2) donor concentration and (3) aid modality.
more
The WHO handbook “Epidemiological Data Analysis for the Early Warning Alert and Response Network (EWARN) in Humanitarian Emergencies” explains how to collect, analyse, interpret, and share health data during crises such as conflicts or natural disasters. It is a practical guide for health and su
...
rveillance officers to detect disease outbreaks early and guide quick public health responses. The document outlines steps for managing data at different levels (local, regional, national), analysing disease trends by time, place, and person, and using indicators to monitor outbreak risks. It also provides methods for interpreting and communicating results clearly to decision-makers to support effective health interventions in emergencies.
more
Global tuberculosis report 2025
recommended
The WHO Global tuberculosis report 2025 provides a comprehensive and up-to-date assessment of the TB epidemic and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels. This is done in the context of global TB commitments, strategies and targets.
...
The 2025 edition of the report is, as usual, based primarily on data gathered by WHO from national ministries of health in annual rounds of data collection. In 2025, 184 countries and areas with more than 99% of the world’s population and TB cases reported data.
more
Building true health security in a global age. Findings and recommendations of the Global Council. In landmark findings based on two years of research and convenings around the world, the new report shows that high levels of inequality are linked to outbreaks becoming pandemics and that inequality i
...
s undermining national and global responses, making pandemics more disruptive, deadly, and longer in duration. The report also shows that pandemics increase inequality, fuelling a cycle that research shows is visible not just for COVID-19, but also for AIDS, Ebola, Influenza, Mpox and beyond.
more
Progress report and road map. Countries included in this report: Algeria, Afghanistan, Bahrain, Djibouti, Egypt, the Islamic Republic of Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, State of Palestine, Saudi Arabia, Somalia, Sudan, the Syrian Arab Republic, Tunisia, Un
...
ited Arab Emirates, Yemen.
To support countries in the region to achieve triple elimination goals, this report collects and assesses national policies and key indicators on EMTCT efforts against WHO criteria for validation of the EMTCT of HIV, syphilis and HBV. Based on analysis and consultations with national policymakers, the report provides a Road Map for countries at different stages of readiness to follow towards triple elimination goals.
more
Renforcement de la surveillance et du partage d’informations à l’échelle transfrontalière en Afrique
Le document intitulé « Strategic Framework for Strengthening Cross-Border Surveillance and Information Sharing in Africa » présente une stratégie coordonnée élaborée par Africa CDC afin d’améliorer la surveillance de la santé publique et la collaboration au-delà des frontières national
...
es en Afrique. Il met en évidence le défi posé par le fait que les maladies infectieuses se propagent fréquemment au-delà des frontières en raison des mouvements de population, du commerce et des migrations, tandis que les systèmes de surveillance et les mécanismes de partage des données restent souvent centrés sur le niveau national et fragmentés.
Le cadre stratégique propose de renforcer la coordination régionale, d’harmoniser les systèmes de surveillance, d’améliorer le partage d’informations entre les pays et de développer les capacités des laboratoires ainsi que des ressources humaines. Il souligne également l’importance de la détection rapide des menaces sanitaires transfrontalières, des enquêtes conjointes sur les flambées épidémiques et d’une meilleure communication entre les États membres. Dans l’ensemble, le document vise à renforcer la préparation, les systèmes d’alerte précoce et la réponse collective aux menaces de santé publique sur le continent africain.
more
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat
...
e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
more
As the number of transboundary pest and animal and foodborne disease outbreaks rises, so does the number of people who are chronically hungry due to these and other factors. The correlation can be explained by the link between our health and that of the planet. We rely on land and sea for the produc
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tion of safe and quality foods for our daily nourishment. Pests and disease epidemics negatively impact the quality, quantity and safety of our food sources, and cripple economic growth and efficiencies in production. Furthermore, the epidemic and endemic levels of the pathogens and disease vectors can be difficult to control. This is why FAO stresses and promotes the special efforts required for cost-effective preventive measures rather than the more expensive control, disinfestation, treatment and disposal measures. When preventive measures are late or difficult, preparedness and contingency plans must be in place to enable rapid response. Early warning systems, based on close monitoring, surveillance, and timely reporting are fundamental to warn and empower communities to safeguard their livelihoods and assets by enhancing disease and pest prevention measures and for government services to take immediate measures to protect communities and national economies.
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This publication is based on the list of clinical interventions selected from clinical guidelines on prevention, screening, diagnosis, treatment, palliative care, monitoring and end of life care. This publication addresses medical devices for six types of cancer: breast, cervical, colorectal, leukem
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ia, lung and prostate. The first section defines the global increase in cancer cases, the global goals to manage NCDs and the WHO activities related to these goals. The second section presents the methodology used for the selection of medical devices that support clinical interventions required to screen, diagnose, treat and monitor cancer stages, as well as the provision of palliative care, based on evidence-based information. The third section lists the priority medical devices required to manage cancer in seven different units of health care services: 1. Vaccination, clinical assessment and endoscopy, 2. Medical imaging and nuclear medicine, 3. Surgery, 4. Laboratory and pathology, 5. Radiotherapy, 6. Systemic therapy and 7. Palliative and end of life care
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Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discharge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic o
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r mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
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Le cadre de surveillance basé sur les événements est destiné à être utilisé par les autorités et les
agences responsables de la surveillance et de l'intervention. Ce cadre sert de cadre pour guider les
parties prenantes intéressées par la mise en œuvre de la surveillance basée sur le
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s événements (SBÈ)
en utilisant une approche multisectorielle axée sur l'approche « Une seule santé ». À cette fin, le
document est organisé en chapitres et annexes interconnectés qui peuvent être modifiés et adaptés,
selon les besoins, par les utilisateurs.
Il s'agit d'une version révisée du « Cadre pour la surveillance basée sur les événements » original qui
a été publié en 2018. Ce cadre ne remplace aucun autre matériel SBÈ disponible, mais s'appuie plutôt
sur des documents pertinents ou connexes existants et sert de guide pratique pour la mise en œuvre
de l'SBÈ en Afrique. Ce cadre est conforme à la troisième édition de l'évaluation externe conjointe de
l'OMS pour les indicateurs suivants : systèmes d'alerte précoce renforcés capables de détecter les
événements importants pour la santé publique et la sécurité sanitaire (indicateur D2.1) ; amélioration
de la communication et de la collaboration entre les secteurs et entre les niveaux d'autorité nationaux,
intermédiaires et locaux d'intervention en matière de santé publique en matière de surveillance des
événements importants pour la santé publique (indicateur D2.2) ; et amélioration de la capacité
d'analyse des données aux niveaux national et intermédiaire ( Indicateur D2.3). Au fur et à mesure
que les pays commenceront à mettre en œuvre et à démontrer la fonctionnalité SBÈ, ils garantiront
une augmentation des scores EEC et des progrès vers le respect des exigences décrites dans l'RSI
(Règlement sanitaire international).
En outre, dans les États membres de l'Union africaine qui ont adopté la Surveillance et réponse
intégrées aux maladies (SRIM), ce document complète et peut améliorer la mise en œuvre de l'SRIM,
en particulier pour la 3e édition (2019) qui inclut des composants liés à l'SBÈ.
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This document builds on the Background document prepared for the September 4-5, 2014 Consultation. It includes proposed elements to consider during the development of a framework to assist decision-making at global and national level.
The aim of
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the document is to assist Member States and relevant partners in their discussions to identify the best approaches to ensure the accelerated evaluation and use of available or near-term therapies and vaccines for the treatment and prevention of EVD. The document calls for a coordinated effort by the international community to remove unnecessary obstacles towards this goal.
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The WHO Cholera Vaccine Position Paper (August 2017) highlights the importance of oral cholera vaccines (OCVs) as a key tool in outbreak response and prevention, alongside water, sanitation, and hygiene (WASH) measures. It recommends OCVs for high-risk populations, endemic areas, and humanitarian cr
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ises, emphasizing their effectiveness in reducing cases and mortality. The paper discusses two types of OCVs (Dukoral®, Shanchol™, Euvichol®) and supports the WHO-managed vaccine stockpile for rapid deployment in cholera-prone regions.
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Smallpox eradication was certified in 1980. Mpox has been endemic in Central and West African countries since it was first detected in 1958 . It is a zoonosis; cases are often found close to tropical rainforests where various animals carry the orthopoxvirus that causes the disease. In endemic countr
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ies, most mpox infections in humans result from a primary animal-to-human transmission. Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person, or recently contaminated objects. Transmission can also occur via the placenta from mother to fetus or through close contact during and after birth.
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The effective vaccine management (EVM) workshop, jointly organized by WHO and UNICEF, was attended by participants from 13 countries, who reviewed the various EVM benchmarks, identified the gaps in policies, guidelines, SOPs and job aids, and developed respective country action plans to fill these g
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aps. This meeting report outlines the proceedings and outcomes of the workshop conducted in Bangkok, Thailand, in December 2024
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It is against this background that the Ministry of Health and Sanitation with its partners have
taken the lead to develop Essential Health Services Package (EHSP). The MOHS believes that the
development of EHSP; defining the services that should be available at each level of care
(community to
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tertiary level), for each age cohort, and across each public health functions, not
only allows for more effective and equitable health service delivery, but also for the
establishment of a functional referral system and allocation of appropriate investments for high
impact interventions. The package is expected to set precedence in defining ‘essential’ set of
services for the population in Sierra Leone, structurally promoting integration of health services,
and providing succinct guidance to partners and stakeholders on the country priorities.
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Long-term polio vaccine security – the timely, sustained, and uninterrupted supply of suitable types of affordable, quality-assured polio vaccines – is essential in the global effort to achieve and maintain a polio free world. However, fragmented approaches and short-term planning pose considera
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ble challenges to securing long-term polio vaccine security.
This framework is designed to enhance the efforts of existing structures and workstreams within the Global Polio Eradication Initiative (GPEI) and other stakeholders by improving communication and coordination on vaccine security. Ensuring vaccine security is crucial for maintaining a timely, sustained, and uninterrupted supply of affordable, quality-assured polio vaccines in the global fight to achieve and sustain a polio-free world. However, challenges such as fragmented approaches, short-term planning, a dynamic policy environment, and a diverse product pipeline present significant risks to long-term vaccine security. This framework emphasizes the need for alignment and coordination across key polio operational domains, including Poliovirus Containment, Research and Development, and Vaccine Manufacturing and Supply. It also underscores the critical role of normative frameworks and policies in shaping long-term vaccine strategies that guide these operational areas. Additionally, it highlights the importance of cross-cutting elements such as financing and access to resources, along with the integration of communication, coordination, and advocacy efforts, as essential enablers for achieving vaccine security. To secure long-term vaccine supply, it is imperative to enhance alignment and strengthen coordinated efforts across workstreams and with stakeholders, including vaccine manufacturers.
Recognizing that vaccine security is an ongoing endeavor, requiring continuous monitoring and adaptation, this framework will undergo regular updates and revisions. Initially, the management of the framework will be carried out by the GPEI Vaccine Supply Group (VSG).
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This UNHCR guidance note provides comprehensive recommendations for the prevention and control of malaria in refugee settings worldwide. Aligned with the WHO Global Technical Strategy for Malaria, it outlines strategies to ensure access to effective prevention, diagnosis and treatment, implement sus
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tainable transmission reduction measures and strengthen surveillance systems. The document is intended as a practical resource for humanitarian actors, public health officials and partners involved in planning and implementing malaria programmes in refugee operations, with the aim of reducing malaria-related morbidity and mortality among vulnerable populations.
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