World Health Organization Initiative Research Articles

ИНИЦИАТИВЫ ВСЕМИРНОЙ ОРГАНИЗАЦИИ ЗДРАВООХРАНЕНИЯ В СФЕРЕ ПОВЫШЕНИЯ БЕЗОПАСНОСТИ ПАЦИЕНТОВ И ИХ РЕАЛИЗАЦИЯ В РОССИЙСКОЙ ФЕДЕРАЦИИ

Currently, patient safety is one of the most important areas of healthcare, and it requires global coordinated efforts. The term "patient safety" covers various aspects, including the prevention of errors and adverse events, minimising risks of infections associated with medical care, ensuring proper use of equipment and effective interaction between patients and medical staff. World Health Organization (WHO) as a specialized unit of the United Nations in the field of global health has a unique international position and authority. It collects and analyzes data from around the world, conducts research and consults member countries within its competence, including medical care safety. In the Russian Federation, the movement for patient safety is still in the process of formation, many medical organizations, when implementing modern principles of safe medical care, face a shortage of practical manuals and other methodological materials. This literature review is devoted to the analysis and systematization of WHO initiatives in the field of improving patient safety. The review pays special attention to WHO's practical recommendations for improving patient safety, which can be used in medical organizations. The review also provides an analytical assessment of the implementation of the main activities aimed to improve patient safety in the Russian Federation. Thus, this study will be interesting to a wide range of readers, especially health care managers and medical professionals who plan to implement the principles of safe medical care in their organizations.

Tropical infectious diseases and the skin: Diagnostic and treatment updates since the WHO's integrated campaign against neglected tropical skin diseases

AbstractIntroductionThe World Health Organization (WHO) initiated a unified effort to address skin‐related neglected tropical diseases (NTDs) in 2017. This effort increased attention and resources allocated toward decreasing the burden of tropical skin diseases. It emphasized an “integrated approach” to detect and treat multiple co‐existing NTDs at once. This article will outline new diagnostic tests, treatment options, and vaccine development for neglected tropical skin diseases since the initiative began.Data SourcesA PubMed search of clinical trials, randomized controlled trials, systematic reviews, and meta‐analyses published since 2017 was performed.ResultsThe WHO's initiative has already seen success, increasing the surveillance of leprosy and the distribution of treatment for yaws. It has encouraged the development of new point‐of‐care tests and better‐tolerated treatment options. It has also brought new challenges, with the rise of resistant organisms. Development of point‐of‐care DNA‐RNA‐based testing may improve drug resistance monitoring. New vaccines are needed for long‐term control of skin NTDs in areas with high transmission rates.

Stepwise options for preparing therapeutic plasma proteins from domestic plasma in low- and middle-income countries.

Industrial plasma fractionation, a complex and highly regulated technology, remains largely inaccessible to many low- and middle-income countries (LMICs). This, combined with the limited availability and high cost of plasma-derived medicinal products (PDMPs), creates deficiency of access to adequate treatment for patients in resource-limited countries, and leads to their suffering. Meanwhile, an increasing number of LMICs produce surplus plasma, as a by-product of red blood cell preparation from whole blood, that is discarded because of the lack of suitability for fractionation. This article reviews pragmatic technological options for processing plasma collected from LMICs into therapies and supports a realistic stepwise approach aligned with recent World Health Organization guidance and initiatives launched by the Working Party for Global Blood Safety of the International Society of Blood Transfusion. When industrial options based on contract or toll plasma fractionation programme and, even more, domestic fractionation facilities require larger volumes of quality plasma than is produced, alternative methods should be considered. In-bag minipool or small-scale production procedures implementable in blood establishments or national service centres are the only realistic options available to gradually reduce plasma wastage, provide safer treatments for patients currently treated with non-pathogen-reduced blood products and concurrently improve Good Manufacturing Practice (GMP) levels with minimum capital investment. As a next step, when the available volume of quality-assured plasma reaches the necessary thresholds, LMICs could consider engaging with an established fractionator in a fractionation agreement or a contract in support of a domestic fractionation facility to improve the domestic PDMP supply and patients' treatment.

New Paradigms in the Treatment of Cervical Cancer.

Despite effective screening strategies and the development and implementation of prophylactic high-risk human papillomavirus vaccination, cervical cancer remains a significant public health burden. This burden is most pronounced in under-resourced countries without fully developed screening and vaccination programs, although the disease remains present worldwide, including in industrialized countries. To that end, the World Health Organization (WHO) has an active focus on the elimination of cervical cancer, with objective metrics to be achieved by countries by the year 2030. Although increased vaccination and screening will be needed to approach potential eradication of cervical cancer, as recognized by the WHO initiative, treatment will need to continue to not only be effective in the near term, but to improve outcomes as well. Accordingly, assessments to improve primary treatment options, including surgery for women with early-stage disease, modification of chemoradiation for those with locally advanced cervical cancer, and systemic therapy for those with recurrent or metastatic presentations, are ongoing. Accordingly, we highlight important areas of both recent and ongoing focus as they relate to improving cervical cancer outcomes.

Analysing the Influence of WHO Initiatives on the Scientific Discourse of Noncommunicable Diseases through a Bibliometric Approach.

Noncommunicable diseases (NCDs) present a major public health challenge, prompting their inclusion in the United Nations' 2030 Agenda for Sustainable Development. In response, the World Health Organization (WHO) has implemented various initiatives, including a comprehensive monitoring framework with global targets and indicators. However, the extent to which these initiatives have shaped the scientific discourse remains unclear. This article addresses this knowledge gap through a two-fold approach. Firstly, a bibliometric analysis of 14,187 studies spanning over 60 years is conducted, identifying key contributors and trends. Secondly, the content analysis compares these trends to the goals established by the WHO. The findings indicate that the WHO initiatives have accelerated scientific research, and elevated global targets and indicators as central themes in scholarly discussions, since 2011. This study takes an innovative approach that contributes to the advancement of knowledge in this field, by providing valuable insights into the impact of WHO initiatives on the scientific debate surrounding NCDs, and offering guidance for policymakers, researchers, and stakeholders engaged in combating these diseases.

Defined daily dose definition in medication adherence assessment in asthma

ABSTRACT Adherence to inhaled corticosteroids (ICS) has been described as poor. In adherence studies, if the actual prescribed dosing is not available, generic defined daily doses (DDD) are applied instead when assessing adherence. We evaluated asthma patients’ adherence in a large prospective follow-up survey. We also analysed whether World Health Organization (WHO) and Global Initiative for Asthma (GINA) reference doses give different results. The current study was cross-sectional and included respondents attending to HeSSup follow-up questionnaire in 2012. Altogether 1,141 of 12,854 adult participants answered positively to the question about having asthma. According to the Finnish Social Insurance Institutions’ medication register, 686 of them had purchased ICS medication during 2011. DDDs for ICS by WHO as well as medium doses from GINA report were used as reference doses to evaluate adherence. To estimate adherence to ICS, the proportion of days covered (PDC) over one year was calculated for every patient. If the lower limit of GINA medium ICS dose was used as a reference, 65% of the patients were adherent (PDC ≥ 80%). Use of WHO’s DDD as reference halved the proportion of adherent patients. Adherence was higher among those using a combination inhaler of corticosteroid and long-acting β2-agonist compared to those using steroid only inhalers. Use of WHO’s daily defined doses as reference values may lead to underestimation of adherence to inhaled corticosteroids. Thus, attention should be paid when choosing the reference doses for the evaluation of adherence to inhaled corticosteroids in asthma.

Addressing Social Determinants of Health to Reduce Disparities Among Individuals with Cancer: Insights for Rehabilitation Professionals.

This report aims to provide a framework for cancer rehabilitation professionals to assess social determinants of health in individuals with cancer and discuss strategies that can be implemented in practice to overcome barriers to care. There has been an increased focus in improving patient conditions that can affect access to cancer rehabilitation. Along with government and world health organization initiatives, healthcare professionals and institutions continue to work towards decreasing disparities. Several disparities exist in healthcare and education access and quality, patients' social and community context, neighborhood and built environments, and economic stability. The authors emphasized the challenges that patients who require cancer rehabilitation face that healthcare providers, institutions, and governments can mitigate with outlined strategies. Education and collaboration are essential to make true progress in decreasing disparities in the populations most in need.

The Global Campaign Against Headache and its future relation to IHS and WHO.

Preparations for the Global Campaign Against Headache done jointly with WHO started almost 25 years ago. It was officially incorporated 18 years ago. It is the story of a few dedicated individuals who, together with the World Health Organization, generated epidemiological data all over the world and made use of these data to gradually increase the position of headache disorders, until migraine became number two among all causes of years lost to disability. It is also the story of impressive development of scientific tools, their validation and use in low-income countries. Models of care for headache patients were developed that are adaptable and hence can be implemented in future throughout the world. The last phase of the campaign shall use the impressive data set generated to cause real improvement in the healthcare for people with headache throughout the world. The recent World Health Organization initiative: Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders invites international organizations to collaborate, and headache is mentioned. This calls for the International Headache Society and all its national members and all other organizations involved in headache to work together with Lifting the Burden, the organization in charge of the Global Campaign Against Headache.

Optimal spatial evaluation of a pro rata vaccine distribution rule for COVID-19

The COVID-19 Vaccines Global Access (COVAX) is a World Health Organization (WHO) initiative that aims for an equitable access of COVID-19 vaccines. Despite potential heterogeneous infection levels across a country, countries receiving allotments of vaccines may follow WHO’s allocation guidelines and distribute vaccines based on a jurisdictions’ relative population size. Utilizing economic—epidemiological modeling, we benchmark the performance of this pro rata allocation rule by comparing it to an optimal one that minimizes the economic damages and expenditures over time, including a penalty representing the social costs of deviating from the pro rata strategy. The pro rata rule performs better when the duration of naturally- and vaccine-acquired immunity is short, when there is population mixing, when the supply of vaccine is high, and when there is minimal heterogeneity in demographics. Despite behavioral and epidemiological uncertainty diminishing the performance of the optimal allocation, it generally outperforms the pro rata vaccine distribution rule.

9.G. Workshop: Health in all Policies: key driver for better health still awaiting of greater governing stewardship

Abstract Healthy public policies are those that take accountability of all possible health impacts, acknowledging the causal pathways resulting from the modification of upstream health determinants (e.g. transport strategies, etc.), and related risk factors downstream (e.g. air pollutants). The strategy of Health in All Policies (HiAP), promoted by the World Health Organization (WHO) and adopted by the European Union (EU) in 2006, reinforced the need to reduce inequalities and improve health and wellbeing as essential pillars for a sustainable economic development. Central to HiAP is the notion that health is not only the responsibility of the health sector, but also a shared responsibility with many other sectors. In this context, Health impact Assessment (HIA) was proposed as the combination of methods to support HiAP implementation by providing scientific evidence on the positive and negative effects that any new proposal may have on health and health equity. The COVID-19 pandemic, and the climate change threat, are two of the main challenges that emphasise the need of integrated responses across many sectors to mitigate not only effects on health and inequalities, but also in the economy. However, HiAP and HIA implementation remains almost at a conceptual level, with a few remarkable exceptions in Europe. One of the most relevant reported barriers contributing to this uneven HiAP implementation is the lack of political stewardship and commitment. The difficulties in applying the guiding principles of HiAP (and consequently of HIA) at local, regional, or national governance level are in many cases linked to a conflict between the right to work and mobilization of the economy, with the right to health and reduction of inequities. This is where the role and drive of public health actors comes across, as HiAP requires public health professionals to build partnerships and engage meaningfully with the sectors affecting the social determinants of health and health equity, external to the health sector. A good proxy example to HiAP implementation, facilitating local and regional initiatives with communities, is the WHO initiative of Healthy Cities. The present panel discussion intends to analyse, from different perspectives, why HiAP has not gained a meaningful place within governing contexts, the current and future status of the intersectoral approach, and the advocacy role of public health in this context. The session is scheduled with a first overview presentation followed by a debate framed around the following aspects: – Different perceptions regarding the concrete implementation of HiAP at all political levels. – Perceived barriers or trade-offs for a broader implementation of HiAP. – Role of public health actors in the implementation of HiAP at a strategic, policy level, and how it could gain a more prominent role. – Level of understanding and awareness of the utility of HIA for HiAP implementation by public health actors. Key messages • HiAP, a recognised approach requiring all sectors to address decisions’ health and equity implications for reaching better global health, has not yet been implemented with an overarching vision. • Public Health actors can disentangle political and technical aspects, seeking for synergisms, and clarifying to non-health sectors the complexity and interrelatedness of social health determinants.

WHO competency framework for health authorities and institutions to manage infodemics: its development and features

BackgroundIn April 2020, the World Health Organization (WHO) Information Network for Epidemics produced an agenda for managing the COVID-19 infodemic. “Infodemic” refers to the overabundance of information—including mis- and disinformation. In this agenda it was pointed out the need to create a competency framework for infodemic management (IM). This framework was released by WHO on 20th September 2021. This paper presents the WHO framework for IM by highlighting the different investigative steps behind its development.MethodsThe framework was built through three steps. Step 1 included the preparatory work following the guidelines in the Guide to writing Competency Framework for WHO Academy courses. Step 2 was based on a qualitative study with participants (N = 25), identified worldwide on the basis of their academic background in relevant fields of IM or of their professional experience in IM activities at the institutional level. The interviews were conducted online between December 2020 and January 2021, they were video-recorded and analyzed using thematic analysis. In Step 3, two stakeholder panels were conducted to revise the framework.ResultsThe competency framework contains four primary domains, each of which comprised main activities, related tasks, and knowledge and skills. It identifies competencies to manage and monitor infodemics, to design, conduct and evaluate appropriate interventions, as well as to strengthen health systems. Its main purpose is to assist institutions in reinforcing their IM capacities and implementing effective IM processes and actions according to their individual contexts and resources.ConclusionThe competency framework is not intended to be a regulatory document nor a training curriculum. As a WHO initiative, it serves as a reference tool to be applied according to local priorities and needs within the different countries. This framework can assist institutions in strengthening IM capacity by hiring, staff development, and human resources planning.

Greenhouse Gas Emission Savings in Relation to Telemedicine and Associated Patient Benefits: A Systematic Review.

Introduction: Telemedicine is a rapidly expanding service in the digitization of health care systems. Recently emphasis has been placed on the decarbonization of health care systems with National and World Health Organization initiatives aimed at carbon neutrality toward the mid-21st century. This study investigates greenhouse gas emissions related to telemedicine, its potential role in achieving carbon neutrality and its role in determining policy. We further investigate patient benefits related to telemedicine. Methods: A systematic review was conducted of the PubMed, Medline, EMBASE, EMCARE, CINAHL, and HMIC databases. Eligibility of studies was determined by predefined criteria. Results: A total of 31 studies were identified totaling over 57,000 patients. Carbon savings ranged from 0.69 kg CO2e (carbon dioxide equivalent) to 893 kg CO2e per encounter. Distances saved also ranged from 6.1 to 3,386 km. Further analysis of 18 included studies was conducted for cost savings that ranged from €1.73 in fuel costs to over U.S. $900 in travel related expenses. Similarly, 15 included studies were analyzed for time savings, which ranged from 38 min to 24 h. Conclusions: There are substantial carbon savings to be made with telemedicine systems. Furthermore, there are substantial benefits to patients in terms of both time savings and cost savings. Rural and isolated communities or patients needing tertiary or quaternary care may be a particular cohort that might benefit disproportionally from telemedicine and is an area where the largest per capita emission savings can potentially be made.

Predicting the number of COVID-19 infections and deaths in USA

BackgroundUncertainties surrounding the 2019 novel coronavirus (COVID-19) remain a major global health challenge and requires attention. Researchers and medical experts have made remarkable efforts to reduce the number of cases and prevent future outbreaks through vaccines and other measures. However, there is little evidence on how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection entropy can be applied in predicting the possible number of infections and deaths. In addition, more studies on how the COVID-19 infection density contributes to the rise in infections are needed. This study demonstrates how the SARS-COV-2 daily infection entropy can be applied in predicting the number of infections within a given period. In addition, the infection density within a given population attributes to an increase in the number of COVID-19 cases and, consequently, the new variants.ResultsUsing the COVID-19 initial data reported by Johns Hopkins University, World Health Organization (WHO) and Global Initiative on Sharing All Influenza Data (GISAID), the result shows that the original SAR-COV-2 strain has R0<1 with an initial infection growth rate entropy of 9.11 bits for the United States (U.S.). At close proximity, the average infection time for an infected individual to infect others within a susceptible population is approximately 7 minutes. Assuming no vaccines were available, in the U.S., the number of infections could range between 41,220,199 and 82,440,398 in late March 2022 with approximately, 1,211,036 deaths. However, with the available vaccines, nearly 48 Million COVID-19 cases and 706, 437 deaths have been prevented.ConclusionThe proposed technique will contribute to the ongoing investigation of the COVID-19 pandemic and a blueprint to address the uncertainties surrounding the pandemic.

How is the World Health Organization (WHO) tackling neglected tropical diseases affecting the eye? The case of trachoma and onchocerciasis

Neglected tropical diseases (NTDs) are defined as diseases that mainly affect individuals living in the most deprived populations globally and continue to persist as a consequence of poverty. The World Health Organization (WHO) has estimated that greater than 1.7 billion individuals are affected by NTDs, largely in countries of lower to middle-income or low-income. Several factors influence the persistence of NTDs including inadequate data regarding the conditions, poor political support, ineffective ways to remove human waste safely, and limited availability of clean water. There are 20 currently listed NTDs. Several NTDs can impact eye health such as blinding trachoma and onchocerciasis (river blindness) which table 1 outlines. This article provides an overview of the WHO initiatives to manage trachoma and onchocerciasis, two NTDs that can affect the eyes.

International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines.

Most children with tumors will require one or more surgical interventions as part of the care and treatment, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumors (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life. It is important for surgeons to adhere to sound pediatric surgical oncology principles, as they are closely associated with improved local control and survival. Unfortunately, there is a significant disparity in survival rates in low and middle income countries, when compared to those from high income countries.The International Society of Paediatric Surgical Oncology (IPSO) is the leading organization that deals with pediatric surgical oncology worldwide. This organization allows experts in the field from around the globe to gather and address the surgical needs of children with cancer. IPSO has been invited to contribute surgical guidance as part of the World Health Organization Initiative for Childhood Cancer. One of our goals is to provide surgical guidance for different scenarios, including those experienced in High- (HICs) and Low- and Middle-Income Countries (LMICs). With this in mind, the following guidelines have been developed by authors from both HICs and LMICs. These have been further validated by experts with the aim of providing evidence-based information for surgeons who care for children with cancer.We hope that this initiative will benefit children worldwide in the best way possible.Simone Abib, IPSO PresidentJustin T Gerstle, IPSO Education Committee ChairChan Hon Chui, IPSO Secretary

Cholera Prevention, Control Strategies, Challenges and World Health Organization Initiatives in the Eastern Mediterranean Region: A Narrative Review

Cholera Prevention, Control Strategies, Challenges and World Health Organization Initiatives in the Eastern Mediterranean Region: A Narrative Review

COVID‐19 Vaccine Inequity: High time to calibrate the global moral compass

COVID‐19 Vaccine Inequity: High time to calibrate the global moral compass

Epidemiology of Malaria in East Nusa Tenggara Province in Indonesia: Protocol for a Cross-sectional Study.

BackgroundMalaria is a global pandemic that results in approximately 228 million cases globally; 3.5% of these cases are in Southeast Asian countries, including Indonesia. Following the World Health Organization (WHO) initiative, Indonesia is in the process of achieving malaria-free zone status by 2030. However, the eastern part of Indonesia, including the East Nusa Tenggara Province (ENTP), still has a disproportionately high rate of malaria.ObjectiveThe aims of this cross-sectional study are to determine the awareness and knowledge, attitude, and practice toward various aspects of malaria among rural adults and their associated factors, including sociodemographic factors and ethnicities; assess the gap between coverage of, access to, and use of long-lasting insecticide-treated nets (LLINs) among the households; estimate the prevalence of and factors associated with malaria in rural adults; and develop a risk prediction model for malaria.MethodsA multistage cluster sampling procedure with a systematic random sampling procedure at cluster level 4 was applied to recruit 1503 adults aged 18 years or older from the ENTP. Each participant participated in a face-to-face interview to assess their awareness and knowledge, attitude, and practice toward aspects of malaria, practices of sleeping under LLINs, and history of malaria. Information on sociodemographic, environmental, and lifestyle factors was also documented. The proportion of knowledge, attitude, and practice toward aspects of malaria and their variations across different sociodemographic and ethnic groups will be analyzed using descriptive statistics and chi-square tests. Coverage and access to LLINs will be evaluated based on the WHO recommendations. Malaria risk factors will be analyzed using logistic regression. Multilevel logistic regression will be applied to estimate the risk score for malaria.ResultsOf the total participants, 99.46% (1495/1503) of rural adults from 49 villages in the ENTP participated in a face-to-face interview from October to December 2019. The study results are expected to be published in peer-reviewed journals.ConclusionsThe best malaria risk prediction model will be developed in this study. In this protocol, we developed a methodology to provide new evidence to guide health policy in supporting the ENTP government’s expectation to achieve the malaria-free rating by 2030.International Registered Report Identifier (IRRID)DERR1-10.2196/23545

An initiative of cooperation in Zika virus research: the experience of the ZIKABRA study in Brazil

BackgroundThe Zika virus outbreak has triggered a set of local and global actions for a rapid, effective, and timely public health response. A World Health Organization (WHO) initiative, supported by the Department of Chronic Condition Diseases and Sexually Transmitted Infections (DCCI) of the Health Surveillance Secretariat (SVS), Brazil Ministry of Health (MoH) and other public health funders, resulted in the start of the “Study on the persistence of Zika virus in body fluids of patients with ZIKV infection in Brazil – ZIKABRA study”. The ZIKABRA study was designed to increase understanding of how long ZIKV persists in bodily fluids and informing best measures to prevent its transmission. Data collection began in July 2017 and the last follow up visit occurred in 06/26/2020.MethodsA framework for the ZIKABRA Cooperation initiative is provided through a description and analysis of the mechanisms, strategies and the ethos that have guided the models of international governance and technical cooperation in health for scientific exchange in the context of a public health emergency. Among the methodological strategies, we included a review of the legal documents that supported the ZIKABRA Cooperation; weekly documents produced in the meetings and working sessions; technical reports; memorandum of understanding and the research protocol.ConclusionWe highlight the importance of working in cooperation between different institutional actors to achieve more significant results than that obtained by each group working in isolation. In addition, we point out the advantages of training activities, ongoing supervision, the construction of local installed research capacity, training academic and non-academic human resources, improvement of laboratory equipment, knowledge transfer and the availability of the ZIKABRA study protocol for development of similar studies, favoring the collective construction of knowledge to provide public health emergency responses. Strategy harmonization; human resources and health services; timing and recruiting particularities and processing institutional clearance in the different sites can be mentioned as challenges in this type of initiative.

"Digital Health Earth": towards a global healthcare management geolocating human health condition by means of space technology

Healthcare providers such as the World Health Organization, transnational and global health initiatives, the national healthcare systems, down to the smallest villages and individual practitioners and professionals could benefit from geo referential data and metadata and 3D digital assets provided by space technology. Health prevention and literacy programs, mortality and morbidity rates, including contextual statistical data about populations and territories are being already produced and accessible. The hypothetical frame of a Digital Health Earth hereto presented could be performed as the interoperability of 3D representations of sectors of territories and geolocalized layers about health and environment. SDG Goals crossed with WHO programs and available data can become the premises for the design and development of a global representation of healthcare situations, highlighting priorities and disseminating data by intuitive and interactive modes of visualization as it is already happening with 2D dashboards about COVID-19 pandemic. Healthcare practitioners, professionals, health managers, but also patients, proxy, social workers, laypeople, stakeholders and media could benefit from visualizing and comparing Digital Earth health data. Concerns about privacy, digital divide and social exclusion from primary care services and how quality of lives might occur are considered here. As a consequence of Space Technology, especially for its connection with the Satellite industry, Digital Health Earth, will contribute to the development of a new added value economic branch inside the increasing market of the Space Economy Revolution.