The COVID-19 Law Lab initiative gathers and shares legal documents from over 190 countries across the world to help states establish and implement strong legal frameworks to manage the pandemic. The goal is to ensure that laws protect the health and wellbeing of individuals and communities and that ...they adhere to international human rights standards.
The COVID-19 Law Lab is a database of laws that countries have implemented in response to the pandemic. It includes state of emergency declarations, quarantine measures, disease surveillance, legal measures relating to mask-wearing, social distancing, and access to medication and vaccines. The database will continue to grow as more countries and themes are added.
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Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully functioning basic water, sanitation and hygiene (WASH) services in all health care facilities. Such services are needed to provide quality care, ensure ad...herence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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The key objective is to celebrate, source, and supply innovations across 12 COVID-19 categories (i.e. response areas). The growing list of 800+ featured innovations includes those that are ready to deploy, plus innovations that could be adapted for COVID-19 responses, or inspire new, much-needed sol...utions. A smaller list is identified as COVID-19 Recognized Innovations for their response efforts so others can more easily find and use them. We are also actively sourcing new innovations designed in response to COVID-19. We hope you find it valuable as we come together to address this global challenge, and would welcome your support so we can continue to help use innovation in tackling future crises yet to come.
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Our previous articles, Coronavirus: Why You Must Act Now, The Hammer and the Dance, and Out of Many, One have gathered over 60 million views together and have been translated into over 40 languages. This installment is part 3 (part 1 and part 2) of our 4th article, Learning How to Dance, a series th...at focuses on the specific steps required to open up the economy. Translations below, more welcome. To receive the next installments and articles, sign up here.
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Diphtheria is caused by Corynebacterium species, mostly by toxin-producing Corynebacterium diphtheriae and rarely by toxin-producing strains of C. ulcerans and C. pseudotuberculosis. The most common type of diphtheria is classic respiratory diphtheria, whereby the exotoxin produced characteristicall...y causes the formation of a pseudomembrane in the upper respiratory tract and damages other organs, usually the myocardium and peripheral nerves. Acute respiratory obstruction, acute systemic toxicity, myocarditis and neurologic complications are the usual causes of death. The infection can also affect the skin (cutaneous diphtheria). More rarely, it can affect mucous membranes at other non-respiratory sites, such as genitalia and conjunctiva.
C. diphtheriae is transmitted from person to person by intimate respiratory and direct contact; in contrast, C. ulcerans and C. pseudotuberculosis are zoonotic infections, not transmitted person-to-person. The incubation period of C. diphtheriae is two to five days (range 1– 10 days). A person is infectious as long as virulent bacteria are present in respiratory secretions, usually two weeks without antibiotics, and seldom more than six weeks. In rare cases, chronic carriers may shed organisms for six months or more. Skin lesions are often chronic and infectious for longer periods. Effective antibiotic therapy (penicillin or erythromycin) promptly terminates shedding in about one or two days.
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The Community Health Community of Practice (CH CoP) builds on the Institutionalisation Community Health Conference co-hosted by USAID and UNICEF in Johannesburg in March 2017. Conceived as an ‘open space’ in terms of both contribution and access to knowledge, it aims at gathering practitioners, ...policy makers, researchers, program implementers and other experts actively involved in the technical or policy development of community health programs in low- and middle-income countries. It offers a network to share your country experience with other countries facing similar challenges; access to global knowledge on community health and its institutionalisation; opportunities for learning, exchanging and debating; constant information on new theoretical, operational or empirical developments in this domain of knowledge. The CoP is facilitated by an international team based in Africa, Asia and Europe. The CH CoP is supported by UNICEF in collaboration with USAID.
accessed 23.07.2021
Collectivity Platform has more group networks to join. The Platform is also available in French.
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The Healthy Living Toolkit is developed to educate refugees, immigrants, resettlement agencies, clinics, community based organizations, and other service providers on refugee health issues. The toolkit presents material in a culturally appropriate manner and is intended to help health care-related p...rofessionals more effectively assist refugees and immigrants and reduce health disparities among these populations. The toolkit is available in multiple languages
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Version 1.0, 2014-11-21
Introduction:
This document lists TB indicators that can be derived from the recording and reporting tools defined
in Definitions and reporting framework for tuberculosis – 2013 revision (WHO/HTM/TB/2013.2).
Geneva, World Health Organization; 2013. (http://www.who.int/t...b/publications/definitions/en/).
More details on the rationale, calculation and use of these indicators are available in the following
publications:
• Understanding and using tuberculosis data (WHO/HTM/TB/2014.09). Geneva, World Health
Organization. 2014.
(http://www.who.int/tb/publications/understanding_and_using_tb_data/en/)
• Companion handbook to the WHO guidelines for the programmatic management of drugresistant
tuberculosis (WHO/HTM/TB/2014.11). Geneva, World Health Organization. 2014.
(http://www.who.int/tb/publications/pmdt_companionhandbook/en/)
• A guide to monitoring and evaluation for collaborative TB/HIV activities: 2014 revision. Geneva,
World Health Organization. 2014.
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In recent years, Rwanda has been on the fast track to achieve major health improvements for its entire population. With the support of government agencies and various non-governmental partners, the Ministry of Health (MoH) has endeavored to decentralize Rwanda’s health system and bring health serv...ices closer to the people. Guided by multitude of national and international development frameworks, Rwanda’s healthcare successes include the establishment of a community health insurance scheme (mutuelle de santé), a system of cooperative-financed community health workers in every village, and interventions for researching, preventing, and treating diseases like HIV/AIDS, TB, and malaria.
As the MoH continues to design innovative means to reach and surpass its prescribed health outcome targets, it will hold as core principles the integration of service provision, the increase in healthcare capacity, and the attainment of sustainable funding sources. Rwanda is committed to achieving the Millennium Development Goals by 2015 and has declared Family Planning (FP) a national priority for poverty reduction and socioeconomic development of the country. Modern contraceptive use has more than quadrupled from 2005 to 2010, rising from 10% to 45%, but the government’s Economic Development and Poverty Reduction Strategy calls for an increase the modern contraceptive prevalence to 70% by 2016. While structural changes in health care and supply chains have led to noteworthy improvements in FP and other services, there are still many challenges that must be overcome. As such, a strategic plan is needed to coordinate FP efforts around a well-defined set of objectives and responsibilities.
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The United Nations Children's Fund (UNICEF), the International Organization for Migration (IOM), Georgetown University, and the United Nations University have today launched new guidelines to provide the first-ever global policy framework that will help protect, include, and empower children on the ...move in the context of climate change.
The Guiding Principles for Children on the Move in the Context of Climate Change provides a set of 9 principles that address the unique and layered vulnerabilities of children on the move both internally and across borders as a result of the adverse impacts of climate change. Currently, most child-related migration policies do not consider climate and environmental factors, while most climate change policies overlook the unique needs of children.
The guidelines note that climate change is intersecting with existing environmental, social, political, economic, and demographic conditions contributing to people’s decisions to move. In 2020 alone, nearly 10 million children were displaced in the aftermath of weather-related shocks. With around one billion children – nearly half of the world’s 2.2 billion children – living in 33 countries at high risk of the impacts of climate change, millions more children could be on the move in the coming years.
Developed in collaboration with young climate and migration activists, academics, experts, policymakers, practitioners, and UN agencies, the guiding principles are based on the globally ratified Convention on the Rights of the Child and are further informed by existing operational guidelines and frameworks.
Recommendations for safeguarding the rights and well-being of children regardless of their location or migration status.
The guiding principles provide national and local governments, international organizations and civil society groups with a foundation to build policies that protect children’s rights. The organizations and institutions are calling on governments, local and regional actors, international organizations, and civil society groups to embrace the guiding principles to help protect, include, and empower children on the move in the context of climate change.
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Des efforts considérables ont été menés pour apporter aux
populations rurales du continent africain des soins de base. Mais
la qualité de ces soins reste aujourd’hui peu satisfaisante car le
médecin généraliste est le plus souvent absent en première
ligne. Cette situation est paradoxa...le en regard du nombre de
médecins formés dans les facultés en Afrique francophone et à
Madagascar. Le déficit en médecin généraliste, exerçant dans les
zones rurales, reste particulièrement préoccupant alors que
les jeunes médecins sans emploi se multiplient dans les villes.
L’ONG Santé Sud, depuis plus de vingt ans, propose un concept
– la médecine générale communautaire – qui, associé à un dispositif
d’accompagnement, a permis l’installation de plus de deux
cents médecins généralistes communautaires au Mali et à
Madagascar. Ce concept a pour intérêt d’associer, dans une même
pratique, la médecine de famille et les Soins de Santé Primaires.
S.F.S.P. | « Santé Publique »
2014/HS S1 | pages 59 à 65
Considerable effort has been made to provide rural African
populations with basic health care, but the quality of this care
remains unsatisfactory due to the absence of first-line GPs. This is
a paradoxical situation in view of the large number of physicians
trained in medical schools in French-speaking Africa and
Madagascar. of the lack of GPs working in rural areas is a real
concern, as many young doctors remain unemployed in cities.
For more than 20 years, the NGO Santé Sud has proposed a
Community General Medicine concept, which, combined with
a support system, has allowed the installation of more than
200 community GPs in Mali and Madagascar. The advantage of
this concept is that it provides family medicine and primary health
care in the same practice.
S.F.S.P. | « Santé Publique »
2014/HS S1 | pages 59 à 65
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide...miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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Poor diets are the major cause of death and disease globally, driving high levels of obesity and noncommunicable diseases. Cheap, heavily marketed, ultra-processed, energy-dense and nutrient-poor food and drinks that are high in fat, sugar and salt play a major role. The high-sugar content of these ...products leads to consumption levels much higher than recommended. The World Health Organization recommends that sugar intake should be reduced to just 5% of energy intake by using fiscal policies and food and drink reformulation strategies. Over the previous decade, the government of the United Kingdom of Great Britain and Northern Ireland has implemented several policies aimed at reducing sugar intake. We compare the soft drinks industry levy and the sugar reduction programme, examining how differences in policy design and process may have influenced the outcomes. Success has been mixed: the mandatory levy achieved a reduction in total sugar sales of 34.3%, and the voluntary reduction programme only achieved a 3.5% reduction in sugar levels of key contributors to sugar intake (despite a target of 20%). Both policies can be improved to enhance their impact, for example, by increasing the levy and reducing the sugar content threshold in the soft drinks industry levy, and by setting more stringent subcategory specific targets in the sugar reduction programme. We also recommend that policy-makers should consider applying a similar levy to other discretionary products
that are key contributors to sugar intake. Both approaches provide valuable learnings for future policy in the United Kingdom and globally
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Diabetes is one of the leading causes of death globally. India is home to the second-largest population suffering from diabetes. This underscores the need to build capacity of primary care physicians (PCPs) for better disease management. This narrative review article aims to describe the emergence o...f diabetes education and capacity-building programs for PCPs and its current situation in India. The review highlighted that major emphasis on diabetes was given only when the WHO estimated that morbidity and mortality due to diabetes would increase to 35% in India. As a result, National Diabetes Control Program was launched in 1987. Yet, very little attention was paid to diabetology in under-graduation. In the last decade, few public and private institutions have developed diabetes related capacity-building programs for PCPs independently or in collaborations. These programs include 16 fellowships, 4 diplomas, 12 certificate programs, and 6 other diabetes training programs, which have their own pros and cons. As medical science is changing rapidly, PCPs need to upgrade their skills and knowledge regularly to manage NCDs such as diabetes more effectively and efficiently. This can be possible only if scientific, evidence-based, and quality-oriented capacity-building programs are provided to the healthcare workforce.
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Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment nee...ds of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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With the growing prevalence of type 2 diabetes, particularly in emerging countries, its management in the context of available resources should be considered. International guidelines, while comprehensive and scientifically valid, may not be appropriate for regions such as Asia, Latin America or Afr...ica, where epidemiology, patient phenotypes, cultural conditions and socioeconomic status are different from America and Europe. Although glycaemic control and reduction of micro- and macrovascular outcomes remain essential aspects of treatment, access and cost are major limiting factors; therefore, a pragmatic approach is required in restricted-resource settings. Newer agents, such as sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in particular, are relatively expensive, with limited availability despite potentially being valuable for patients with insulin resistance and cardiovascular complications. This review makes a case for the role of more accessible second-line treatments with long-established efficacy and affordability, such as sulfonylureas, in the management of type 2 diabetes, particularly in developing or restricted-resource countries.
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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.
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Background: Data on burden of peripheral artery disease (PAD) and its attributable risk factors are valuable for policymaking. We aimed to estimate the burden and risk factors for PAD from 1990 to 2019.
Methods: We extracted the data on prevalence, incidence, death, years lived with disability (YLD...s), and years of life lost (YLLs) from the Global Burden of Disease Study 2019 to measure PAD burden. Moreover, the attributable burden to PAD risk factors was also estimated.
Results: Globally, in 2019, 113,443,017 people lived with PAD and 10,504,092 new cases occurred, resulting in 74,063 deaths, 500,893 YLDs, and 1,035,487 YLLs. The absolute numbers of PAD prevalent and incident cases significantly increased between 1990 and 2019, contrasting with the decline trends in age-standardized prevalence and incidence rates. However, no statistically significant changes were detected in the global age-standardized death or YLL rates. The burden of PAD and its temporal trends varied significantly by location, gender, age group, and social-demographic status. Among all potentially modifiable risk factors, age-standardized PAD deaths worldwide were primarily attributable to high fasting plasma glucose, followed by high systolic blood pressure, tobacco, kidney dysfunction, diet high in sodium, and lead exposure.
Conclusion: PAD remained a serious public health problem worldwide. More strategies aimed at implementing cost-effective interventions and addressing modifiable risk factors should be carried out, especially in regions with high or increasing burden.
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Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing.
This updated cross-sectional study used the same methods as the International study of Asthma and Allergies in Chi...ldhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993–95), ISAAC Phase III (2001–03), or both. We included individuals from two age groups (children aged 6–7 years and adolescents aged 13–14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders.
Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993–2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (–0·37, 95% CI –0·69 to –0·04) and an increase in ever having asthma (1·25, 0·67 to 1·83) and night cough (4·25, 3·06 to 5·44), which was also found in children (3·21, 1·80 to 4·62). The prevalence of current wheeze decreased in low-income countries (–1·37, –2·47 to –0·27], in children and –1·67, –2·70 to –0·64, in adolescents) and increased in lower-middle-income countries (1·99, 0·33 to 3·66, in children and 1·69, 0·13 to 3·25, in adolescents), but it was stable in upper-middle-income and high-income countries.
Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.
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Lancet. 2019; 394: 1212-1214