Yaws, a neglected tropical disease (NTD) of the skin caused by the bacterium Treponema pallidum subspecies pertenue, is targeted in the latest WHO NTD Roadmap for eradication by 2030. In January, 2022, WHO published a manual that outlines the key activities that Ministries of Health in endemic count...ries should undertake to achieve this goal. The aim of the manual is to provide guidance on surveillance and evaluation of yaws as programmes progress towards eradication. However, yaws eradication in Africa faces several challenges.
more
The document presents Cameroon's National Response Plan for the 2018 cholera outbreak, covering August to October 2018. It highlights the epidemiological situation, with outbreaks reported in the North and Central regions and a total of 109 suspected cases and 9 deaths by July 2018. The plan outline...s strategies for controlling the epidemic, including epidemiological surveillance, improved access to clean water, sanitation, mass vaccination, community awareness campaigns, and hospital and community-based treatment.
The response is coordinated by the Ministry of Public Health, WHO, and various partners, focusing on early detection, rapid response, and multi-sectoral collaboration. Challenges include poor sanitation, limited healthcare infrastructure, and cross-border disease transmission risks. The plan emphasizes resource mobilization, monitoring, and evaluation to contain the outbreak and prevent future cases.
more
On 13 August 2024, Africa Centres for Disease Control and Prevention (Africa CDC) declared the ongoing Mpox outbreak a Public Health Emergency of Continental Security (PHECS). This was followed the next day by the World Health Organization (WHO), which extended the alert internationally as a public ...health emergency of international concern (PHEIC). After these declarations, many countries have made efforts to mobilize resources to introduce or expand laboratory testing, surveillance, and response activities. In particular, as the number of suspected cases surges in the Democratic Republic of Congo (DRC), Burundi, and the Central African Republic, and an increasing number of new countries report cases, there is an urgent need to implement testing to strengthen the Mpox response. However, access to appropriate quality assured diagnostics is a challenge. There is limited information on important characteristics, such as available test kits’ performance and ability to detect relevant clades.
To address the challenge of mpox access in the continent, the Africa CDC Diagnostic Advisory Committee (DAC) met in Kigali from 19-23 August 2024 to review the available evidence on molecular tests for Mpox and to shortlist tests that may be useful for Mpox testing in countries. The shortlist aims to provide guidance to Africa CDC, countries and partners on appropriate high-quality molecular tests to procure and use for the mpox response.
more
To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Afric...a through the WHO neglected
tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme
in the region while we identify the key remaining challenges in achieving an Africa free of LF.
more
The present National action plan on antimicrobial resistance (AMR) with component of antimicrobial consumption (AMC) covering both human and agriculture sectors was developed based on the World Health Organization's (WHO) Global plan on AMR dated 2015. With the purpose to develop this plan, in May 2...016 an intersectoral and interagency working group was established under coordination of the State Sanitary and Epidemiological Surveillance Service (SSESS), the Ministry of Health and Social Protection of Population (MoHSPP) of the Republic of Tajikistan. With technical as- sistance from the WHO a number of seminars, consultation meetings and workshops were conducted to identify country's priority areas and required actions for AMR con- tainment and AMC and control.
more
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
Am. J. Trop. Med. Hyg., 106 (Suppl 5), 2022, pp. 56–60. Lymphatic filariasis (LF) is a parasitic disease that is a major cause of chronic disability in the developing world. According to the 2021–2030 road map for neglected tropical diseases (NTDs) published by the World Health Organization (WHO...), the global goal for LF is elimination as a public health problem by 2030 through repeated rounds of mass drug administration (MDA). Critical components of any elimination program are monitoring and surveillance. Appropriate assessment tools and methods are needed for each stage of an elimination program; mapping to identify which areas require intervention, monitoring to assess the impact of interventions, and post-intervention surveillance to validate elimination or detect recrudescence.
more
The UNHCR Cholera Response Plan (October 2022 – March 2023) outlines efforts to combat the cholera outbreak in Lebanon, which was declared in October 2022. The plan, led by the Ministry of Public Health with support from UNHCR, WHO, UNICEF, and NGOs, focuses on prevention, response, and surveillan...ce. Key actions include oral cholera vaccination campaigns, rapid diagnostics, strengthening healthcare facilities, and improving hygiene and sanitation in high-risk refugee settlements and collective shelters. The response also emphasizes risk communication and community engagement to raise awareness and ensure early detection. The plan targets 120,000 individuals and requires $8.5 million in funding to provide life-saving support and containment measures.
more
Antimicrobial resistant (AMR) organisms are increasing globally, threatening to render existing treatments ineffective against many infectious diseases. In Africa, AMR has already been documented to be a problem for HIV and the pathogens that cause malaria, tuberculosis, typhoid, cholera, meningitis..., gonorrhea, and dysentery. Recognizing the urgent need for action, the World Health Assembly adopted the Global Action Plan on Antimicrobial Resistance in May 2015. In accordance with the Global Action Plan and to meet needs specific to Africa, Africa CDC will establish the Anti-Microbial Resistance Surveillance Network (AMRSNET). AMRSNET is a network of public health institutions and leaders from human and animal health sectors who will collaborate to measure, prevent, and mitigate harms from AMR organisms.
more
MEDBOX Issue Brief 26. Cholera is an acute diarrhoeal infection caused by eating or drinking food or water that is contaminated with the
bacterium Vibrio cholerae. Cholera remains a global threat to public health and is an indicator of inequity and lack of
social development. Researchers have esti...mated that every year, there are 1.3 to 4.0 million cases of cholera, and 21
000 to 143 000 deaths worldwide due to the infection.
However, cholera remains a neglected and underreported disease. Many cases are not recorded due to limitations in
surveillance systems and fears of potential impact on trade or tourism.
Today cholera affects 47 countries across the globe. Almost every developing country faces cholera outbreaks or
the threat of cholera. Major ongoing outbreaks are being reported from Afghanistan, Bangladesh, Democratic
Republic of Congo, Ethiopia and Nigeria. Major outbreaks are currently in Syria and Haiti.
Therefore, MEDBOX decided to produce issue briefs on cholera and available resources in Arabic, English and
French.
more
The Ethiopia Multi-Sectorial Cholera Elimination Plan (2022-2028) outlines a national strategy to eliminate cholera in Ethiopia by 2028. The plan follows the Global Roadmap to End Cholera by 2030 and is based on six key pillars: Leadership & Coordination, Water, Sanitation & Hygiene (WASH), Surveill...ance & Reporting, Use of Oral Cholera Vaccines (OCV), Healthcare System Strengthening, and Community Engagement.
Ethiopia has historically faced recurrent cholera outbreaks due to poor sanitation, unsafe water, and weak health infrastructure. The plan prioritizes high-risk areas (hotspot woredas) and aims to reduce cholera-related mortality by 90% by 2028. It includes efforts to improve WASH conditions, strengthen disease surveillance, enhance rapid response capabilities, expand vaccination campaigns, and integrate cholera control into broader health policies.
The government, in collaboration with international partners such as WHO, UNICEF, and the Global Task Force for Cholera Control (GTFCC), will implement and monitor the plan. The estimated budget for the initiative is $390 million over eight years. Ethiopia aims to achieve zero cholera transmission in hotspot regions, ensuring sustainable public health improvements.
more
Background
Access to medicines is important for long‐term care of cardiovascular diseases and hypertension. This study provides a cross‐country assessment of availability, prices, and affordability of cardiovascular disease and hypertension medicines to identify areas for improvement in access ...to medication treatment.
Methods and Results
We used the World Health Organization online repository of national essential medicines lists (EMLs) for 53 countries to transcribe the information on the inclusion of 12 cardiovascular disease/hypertension medications within each country's essential medicines list. Data on availability, price, and affordability were obtained from 84 surveys in 59 countries that used the World Health Organization's Health Action International survey methodology. We summarized and compared the indicators across lowest‐price generic and originator brand medicines in the public and private sectors and by country income groups. The average availability of the select medications was 54% in low‐ and lower‐middle‐income countries and 60% in high‐ and upper‐middle‐income countries, and was higher for generic (61%) than brand medicines (41%). The average patient median price ratio was 80.3 for brand and 16.7 for generic medicines and was higher for patients in low‐ and lower‐middle‐income countries compared with high‐ and upper‐middle‐income countries across all medicine categories. The costs of 1 month's antihypertensive medications were, on average, 6.0 days’ wage for brand medicine and 1.8 days’ wage for generics. Affordability was lower in low‐ and lower‐middle‐income countries than high‐ and upper‐middle‐income countries for both brand and generic medications.
Conclusions
The availability and accessibility of pharmaceuticals is an ongoing challenge for health systems. Low availability and high costs are major barriers to the use of and adherence to essential cardiovascular disease and antihypertensive medications worldwide, particularly in low‐ and lower‐middle‐income countries.
more
Second interim report to the SMAC program, DFID Freetown
This report provides further output from an anthropological study of 25 villages affected by Ebola Virus Disease in eastern and central Sierra Leone, undertaken as part of the DFID-funded social mobilization initiative for Ebola prevention in... Sierra Leone. Eight focus group transcripts for 3 villages in Kenema District are presented, covering local responses to health issues, and Ebola in particular. Supporting material from a matching questionnaire-based study of health behavior and perceived causes of Ebola is also provided. Of particular relevance are two summary tables aggregating the questions villagers asked survey teams about Ebola and quarantine-related issues in villages where the epidemic has in effect ceased to be active
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...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.
more
Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures—and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, informa...tion will be needed to support a potential campaign to promote vaccination.
Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects.
Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile.
Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies.
Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.
more
The Cholera Outbreak Guidelines: Preparedness, Prevention, and Control provide a practical field guide for responding to cholera outbreaks. Developed by Oxfam GB, the guidelines combine lessons from past cholera interventions and best practices for effective outbreak management. The document outline...s key strategies, including preparedness planning, rapid response to outbreaks, water and sanitation improvements, hygiene education, and coordination among stakeholders. It covers both non-endemic and endemic cholera outbreaks, offering step-by-step guidance on surveillance, intervention, and monitoring. The aim is to ensure community-based, gender-sensitive, and rapid public health responses to control cholera and minimize mortality.
more
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...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.
more
This Collection links to the websites of providers of free training. We monitor these links regularly, however if the training providers change their websites, some of these links may not work. All other resources on the Humanitarian Library can be downloaded directly from the Library. This Collecti...on is monitored daily to identify new and updated materials.
This Collection contains technical guidelines from leading global institutions to support the operation of medical centres responding to the Covid-19 virus. Current guidance comes from the European Center for disease prevention and control, Centre Hospitalier de Grenoble, Elsevier, Health Protection Surveillance Center, Public Health England, Stadt Essen and the World Health Organisation.
more
The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp...ressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
more
Human African trypanosomiasis (HAT) is a lethal neglected tropical disease (NTD) transmitted by the bite of infected tsetse flies. The disease is also known as “sleeping sickness”. During the 20th century it caused enormous suffering in the endemic areas in sub-Saharan Africa. HAT transmission l...ast soared in the late 1990s, triggering a renewed, coordinated and very successful control effort. In this paper, we present achievements towards HAT elimination, with a focus on the WHO road map targets for 2020. In particular, reported cases continue to decline, from over 30,000 cases per year at the turn of the century to 663 cases in 2020. Despite the impact of the COVID-19 pandemic, HAT surveillance was largely sustained, and the network of health facilities able to diagnose and treat the disease further expanded. Looking to the future, the World Health Organization (WHO) set bold new targets for HAT in its 2021–2030 road map for NTDs, namely: the elimination of transmission of gambiense HAT, which occurs in western and central Africa, and the elimination as a public health problem of rhodesiense HAT, which is found in eastern and southern Africa. The strong commitment of national health authorities and the international community will be essential if these goals are to be achieved.
more