Abstract

The World Health Organization (WHO) is a leading source of trustworthy guidelines in public health, including in emergencies. In addition to standard guidelines produced in preparation for emergency response, WHO has processes and methods for issuing guidelines in the context of urgent public health need, including rapid advice guidelines (production time 2 to 3 months) and health emergency interim guidelines (days to weeks). There are numerous challenges to producing guidelines in response to an emergency in addition to the compressed timeline which necessitates truncating or modifying standard processes. There is frequently a lack of scientific data on the disease or situation at hand, especially early in the event timeline. Resources are limited, particularly the availability of WHO staff and external experts, and disease and emergency response experts may lack knowledge and experience in developing guidelines. Finally, the rapid production of new information and the resultant short shelf‐life of recommendations pose a significant challenge to keeping guidelines up to date. In order to better meet end‐users’ needs, WHO must anticipate areas of uncertainty in emergency response and proactively develop relevant guidelines, explore optimal ways of communicating gaps in knowledge in the field to guideline developers, and promote and participate in research on the sources of bias in guideline development within compressed timeframes.

Highlights

  • The World Health Organization (WHO) is the United Nation's (UN's) directing and coordinating authority on international health for the UN's 194 Member States.[1]

  • Since its inception in 1948, WHO has produced a vast array of technical normative guidance across a broad range of topics, including those related to emergency response

  • WHO guidelines are of several types (Table 1): standard guidelines follow full processes, are based on systematic reviews of the relevant evidence, and involve meetings of external experts at which recommendations are formulated based on explicit criteria and processes

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Summary

INTRODUCTION

The World Health Organization (WHO) is the United Nation's (UN's) directing and coordinating authority on international health for the UN's 194 Member States.[1]. The very short timeline and the frequent paucity of structured scientific evidence necessitate ultra-rapid identification of key questions, the use of existing evidence syntheses and indirect evidence, virtual meetings, and reliance on expert opinion (which is explicit and transparent) These guidelines have a short shelf-life so are labeled “interim” with a commitment to updating. Despite the wide variations in development time, all WHO guidelines adhere to the principles of trustworthy information products: use of explicit and transparent processes and methods; the application of as rigorous an approach as possible to minimize bias in evidence collection, appraisal and synthesis, and in the resultant recommendations; a focus on end-users’ needs; and the production of usable, impactful guidance

CHALLENGES
THE FUTURE
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