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.
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A thesis submitted for the Degree of Master of Theology at the South African Theological Seminary
The regional Migrant Response Plan (MRP) for the Horn of Africa and Yemen includes urgent life-saving humanitarian and protection interventions to improve safe and dignified access to basic services for migrants and host communities while ensuring medium- to long-term actions aimed at addressing the... drivers of migration.
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The present booklet is about gender-responsive substance abuse treatment services for women. It is part of the United Nations Office on Drugs and Crime (UNODC) project to develop tools to support the development and improvement of substance abuse treatment services, based on evidence from the litera...ture and case studies that illustrate practical experiences and lessons learned in providing substance abuse treatment services in various regions of the world.
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The Strategy provides a high-level unifying framework to leverage existing capacities, address barriers and strengthen the use of genomic surveillance in the detection, monitoring and response to public health threats. Genomic surveillance is part of the broader surveillance and laboratory system, a...nd its implementation should reinforce end-to-end capacities including sample collection, diagnostics, data sharing and analysis. The strategy aims to facilitate the connectivity between different disease control programs and surveillance networks. This interoperability will strengthen the cross-cutting essential public health laboratory functions underpinning genomics holistically. The strategy articulates the overarching goal, objectives and strategic actions needed. These are dependent on commitments from countries, partners and WHO for their implementation.
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The Lancet Planetary Health, Vol.5 Issue 2, Feb. 1,2021.
Nationally determined contributions (NDCs) serve to meet the goals of the Paris Agreement of staying “well below 2°C”, which could also yield substantial health co-benefits in the process. However, existing NDC commitments are inadequa...te to achieve this goal. Placing health as a key focus of the NDCs could present an opportunity to increase ambition and realise health co-benefits. We modelled scenarios to analyse the health co-benefits of NDCs for the year 2040 for nine representative countries (ie, Brazil, China, Germany, India, Indonesia, Nigeria, South Africa, the UK, and the USA) that were selected for their contribution to global greenhouse gas emissions and their global or regional influence.
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The far-reaching impacts of the COVID-19 pandemic underscore the critical need for evidence-informed, transparent and inclusive decision-making. Policy-makers have grappled with complex choices amidst uncertainty. They have constantly reassessed response measures while navigating their economic impl...ications and unintended consequences on societal well-being. Effective communication of the basis for these decisions has also posed a challenge, requiring transparency and public trust.
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Reflections from disability research using the ICF in Afghanistan and Cambodia | Working Paper Series: No. 11
Depress Anxiety. 2018 March ; 35(3): 195–208. doi:10.1002/da.22711.
Dans ce rapport, le Partnership for Evidence-Based Response to COVID-19 (PERC), un consortium d’organisations mondiales de santé publique et d’entreprises privées, fait la synthèse des résultats d’une enquête conduite du 29 mars au 17 avril 2020 dans 28 villes des États Membres de l’UA.... Ce rapport présente également les mesures épidémiologiques en matière de transmission de la maladie ainsi que les indicateurs relatives aux déplacements des populations et aux troubles civils. Dans l’ensemble, ces données donnent un aperçu unique des conditions initiales en Afrique pendant cette pandémie en évolution rapide.
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The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches document is part of the WHO Guidance and technical packages on community mental health services set of publications. It provides a detailed description of person-centred and human rights-based ...approaches in mental health, and summary examples of good practice services around the world. It describes the linkages needed with housing, education, employment and social protection sectors, and presents examples of integrated regional and national networks of community-based mental health services. Specific recommendations and action steps are presented for developing community mental health services that respect human rights and focus on recovery. This comprehensive document is accompanied by a set of seven technical packages focused on specific categories of mental health services and guidance for setting up new services.
The WHO Guidance on community mental health services: Promoting person-centred and rights-based approaches is a set of publications that provides information and support to all stakeholders who wish to develop or transform their mental health system and services to align with international human rights standards including the UN Convention on the Rights of Persons with Disabilities.
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This updated implementation guidance is intended for all those who set policy for, or offer care to, pregnant women, families and infants: governments; national managers of maternal and child health programmes in general, and of breastfeeding- and BFHI-related programmes in particular; and health-f...acility managers at different levels (facility directors, medical directors, chiefs of maternity and neonatal wards). The document presents the first revision of the Ten Steps since 1989. The topic of each step is unchanged, but the wording of each one has been updated in line with the evidence-based guidelines and global public health policy.
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Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health system challenge in Mozambique. To address this weakness and decentralize NCD care, training of the primary care workforce is needed. We describe our experience in t...he design and implementation of a cascade training of trainers (ToT) intervention to strengthen the prevention and control of cardiovascular disease.
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continue...s to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health
service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and
the community health team. Our analysis identified key challenges that may impede the strategy’s implementation:
(1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs
from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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This document is for humanitarian health actors working at national and sub-national level in countries facing humanitarian emergencies. It applies to Health Cluster partners, including governmental and non-governmental health service providers.
Based on the IASC Guidelines on Mental Health and Psy...chosocial Support in Emergency Settings (IASC, 2007), it gives an overview of essential knowledge that humanitarian health actors should have about mental health and psychosocial support (MHPSS) in humanitarian emergencies.
This document by the IASC Reference Group for Mental Health and Psychosocial Support was developed in consultation with the IASC Global Health Cluster.
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A technical guide for sputum smear microscopy, initiated by the International Union against Tuberculosis, is designed to be an easy to use reference standard for the collection, storage and transport of sputum specimens and for the examination of sputum smears by direct microscopy. This edition incl...udes updates addressing bio-safety and quality assurance aspects of sputum smear microscopy.
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