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Environmental Health & Climate ChangeInternational Plan, Policy & GuidelinesPublic HealthReportsResearch & Publication

New WHO report to bolster efforts to tackle leading causes of urban deaths

by Public Health Update October 31, 2019
written by Public Health Update

New WHO report to bolster efforts to tackle leading causes of urban deaths

World Health Organization launched a new report ”The power of cities: tackling noncommunicable diseases and road safety” on World Cities Day. It offers tools for city leaders to tackle deaths through non-communicable diseases and road traffic injuries.

A new report by the World Health Organization offers guidance and tools for urban leaders to tackle some of the leading causes of death in cities.

Non-communicable diseases (NCDs) – like heart disease, stroke, cancer and diabetes – kill 41 million people worldwide every year, and road traffic crashes kill 1.35 million.

“Over half the world’s people live in cities, and the numbers are rising,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

“City leaders take decisions that impact on the health of billions, and for cities to thrive, everyone needs access to services that will improve their health – public transport, safe, clean and attractive outdoor spaces, healthy food, and, of course, affordable health services.”

The report, titled ‘The Power of Cities: Tackling Non-Communicable Diseases and Road Traffic Injuries’ is geared towards mayors, local government officials and city policy planners.

Funded by Bloomberg Philanthropies, it highlights key areas where city leaders can tackle the drivers of NCDs, including tobacco use, air pollution, poor diets and lack of exercise, and improve road safety.

“By replicating the most effective measures on a global scale, we can save millions of lives,” said WHO Global Ambassador for NCDs and injuries, and three-term New York City Mayor, Michael R. Bloomberg.

“We’re working to raise awareness among city leaders and policy makers about the real gains that can be achieved when effective programs are in place.”

From anti-tobacco actions in Beijing and Bogor, to road safety initiatives in Accra and Bangkok, a bike sharing scheme in Fortaleza, and actions to create walkable streets for seniors that have reduced elderly pedestrian deaths by 16% in New York City, the report aims to share knowledge between urban policy planners.

Of the 19 case studies cited, 15 are from developing countries, where 85% of premature adult deaths through NCDs take place, and over 90% of road traffic fatalities are recorded.

Over 90% of future urban population growth will be in low or middle-income countries, and seven of the world’s 10 largest cities are in developing countries.

The initiatives cited in the report are similar to those implemented under the Partnership for Healthy Cities initiative, a joint WHO, Bloomberg Philanthropies and Vital Strategies initiative that brings over 50 cities together to share policies and plans on tackling NCDs and injuries.

The network, led by Mr Bloomberg, has helped ensure 216 million people are covered by at least one intervention to protect them from NCDs and road traffic injury since 2017.

Some 193 countries have committed to reducing premature deaths from NCDs by a third by 2030, and halving road traffic deaths and injuries by 2020, through the Sustainable Development Goals.

WHO


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Inside this report; 

Priority Areas (Page no. 18)

  1. Eliminating pollution emissions and ensuring clean energy and air.
  2. Designing cities to promote sustainable urban mobility, including active transport (such as walking or cycling) and recreation, robust urban transport infrastructure, and strong road safety laws.
  3. Implementing sustainable and safe food policies that reduce intake of sugars and salt, and reduce harmful use of alcohol.
  4. Making all environments smokefree, as well as banning all forms of tobacco advertising, promotion and sponsorship.

Ten interventions to address NCDs and road traffic injuries in cities(Page no. 20, 21)

  • MONITOR NCD RISK FACTORS 
  • CREATE A SMOKE-FREE CITY 
  • BAN TOBACCO ADVERTISING 
  • REDUCE THE CONSUMPTION OF SUGAR-SWEETENED BEVERAGES 
  • REDUCE SALT CONSUMPTION
  • CREATE WALKABLE, BIKEABLE, LIVABLE STREETS 
  • CLEANER AIR
  • REDUCE DRINK-DRIVING
  • SPEED MANAGEMENT
  • INCREASE SEAT-BELT AND HELMET USE
Examples of cities working on NCDs and road safety interventions (Page no. 28, 29)
Examples of cities working on NCDs and road safety interventions

Examples of cities working
on NCDs and road safety
interventions


WHO mhGAP toolkit for community providers launched

WHO welcomes landmark UN declaration on universal health coverage

WHO calls for urgent action to reduce patient harm in healthcare

WHO South-East Asia Region sets 2023 target to eliminate measles, rubella

Six WHO South-East Asia countries felicitated for public health achievements

October 31, 2019 0 comments
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Communicable DiseasesNational Plan, Policy & GuidelinesPublic HealthResearch & Publication

National Guideline on Drug Resistant TB Management 2019, Nepal

by Public Health Update October 30, 2019
written by Public Health Update

National Guideline on Drug Resistant TB Management 2019, Nepal

Risk Population for DR-TB (Ref. Page no. 11)

The following categories of TB patients are at risk of having DR-TB and need to be screened for drug resistance;

  1. Close contact of DR-TB case
  2. Previously treated patients who either:
    – failed
    – relapsed
    – returned after loss to follow-up
  3. Smear positive at 2 months or subsequent follow up during first-line treatment
  4. Not getting better / getting worse during continuation phase of the first-line treatment and patients with frequent interruptions and irregular first line drugs.
  5. Health care workers with presumptive TB.
  6. PLHIV, DM and other immunocompromised
  7. Belonging to vulnerable groups such as migrants and refugees

Most patients with presumptive DR-TB will be bacteriologically positive pulmonary cases, but clinically confirmed pulmonary or extrapulmonary TB cases may also present with presumptive DR-TB if they show a clinically unfavorable evolution.

Prevention of drug-resistant TB (Ref. Page no. 6)

  1. Early detection and high-quality treatment of drug-susceptible TB.
  2. Early detection and high-quality treatment of drug-resistant TB.
  3. Effective implementation of infection control measures.
  4. Strengthening and regulation of health systems.
  5. Addressing underlying risk factors and social determinants

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DOWNLOAD PDF FILE


Recommended readings

  • Global Tuberculosis Report 2019: Latest status of the tuberculosis epidemic
  • Dissemination of Findings and Recommendations of Joint External Monitoring Mission(JEMM) of Nepal National Tuberculosis Program
  • National Tuberculosis Programme Annual Report 2018
  • National Strategic Plan for Tuberculosis Prevention, Care and Control 2016 – 2021
  • NTP, Nepal: New TB Treatment Algorithm & Regimen (Updated)
  • WHO announces landmark changes in MDR-TB treatment regimens
  • TB Vaccine results announce a promising step towards ending the emergency
  • 7 million people receive record levels of lifesaving TB treatment but 3 million still miss out

National Guideline on Drug Resistant TB Management 2019, Nepal

National Tuberculosis Management Guideline 2019, Nepal

October 30, 2019 0 comments
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Communicable DiseasesNational Plan, Policy & GuidelinesPublic HealthResearch & Publication

National Tuberculosis Management Guideline 2019, Nepal

by Public Health Update October 30, 2019
written by Public Health Update

National Tuberculosis Management Guideline 2019, Nepal

Introduction (Ref. Page no. 1)

This guideline is to provide basic information about TB and its management to all health workers in Nepal. Early detection, appropriate diagnosis and timely treatment of TB result in good treatment outcomes. Health workers need to be equipped with the right information on the diagnosis and treatment of TB. Poor management of TB results in death and creates drug resistant (DR) TB which is very hard and costly to treat resulting in often poorer outcomes.

All health workers in Nepal regardless of their involvement in TB services should be aware of TB, its transmission and prevention and its diagnosis and management. Health workers managing TB patients need proper guidance in diagnosis and treatment of TB and it is for this purpose that this guideline is produced.

In developing this guideline, the National TB Program takes into consideration the emerging problems of TB/HIV and DR TB as well as other revisions including Latent TB infection made to TB management by World Health Organization. This guideline is therefore, an update from the 2012 General Manual (Third Edition).

Following are the major changes to TB management for Nepal;

  • Only 2 sputum samples required for initial diagnosis of TB.
  • Same-day diagnosis of TB by Microscopy (2 samples same day-1 hour apart)
  • Only 1 sputum sample required for follow up examination.
  • Even new presumptive TB cases should have access to GeneXpert diagnosis wherever it is possible
  • Treatment is not extended at the end of the intensive phase, even though the sputum follow up examination result remains positive at the end of two months, continuation phase is commenced regardless of whether the sputum is positive or not.
  • Streptomycin containing Category II regimen for retreatment cases will No Longer be used in Nepal

New definitions

  • TB suspect is changed to Presumptive TB : Previously treated patients’ definitions have been changed and are based on the outcome of their most recent course of treatment and are independent of bacteriological confirmation or site of disease.
  • The treatment regimen for retreatment TB cases has been removed. All previously treated TB patients will receive new treatment regimen and will be screened for drug resistant TB.
  • Recording and reporting forms have been edited to suit new definitions and change in the treatment regimen 

DOWNLOAD PDF FILE

DOWNLOAD PDF FILE


Recommended readings

  • Global Tuberculosis Report 2019: Latest status of the tuberculosis epidemic
  • Dissemination of Findings and Recommendations of Joint External Monitoring Mission(JEMM) of Nepal National Tuberculosis Program
  • National Tuberculosis Programme Annual Report 2018
  • National Strategic Plan for Tuberculosis Prevention, Care and Control 2016 – 2021
  • NTP, Nepal: New TB Treatment Algorithm & Regimen (Updated)
  • WHO announces landmark changes in MDR-TB treatment regimens
  • TB Vaccine results announce a promising step towards ending the emergency
  • 7 million people receive record levels of lifesaving TB treatment but 3 million still miss out

National Guideline on Drug Resistant TB Management 2019, Nepal

National Tuberculosis Management Guideline 2019, Nepal

October 30, 2019 0 comments
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Communicable DiseasesGlobal Health NewsPublic HealthPublic Health NewsPublic Health Update

TB Vaccine results announce a promising step towards ending the emergency

by Public Health Update October 30, 2019
written by Public Health Update

TB Vaccine results announce a promising step towards ending the emergency

29 Oct 2019

Results from a study, presented at TBScience 2019 on 29th Oct 2019, demonstrated a sustained level of protection against active tuberculosis (TB).

New TB vaccine GSK’s M72/AS01E success announced

The vaccine, known as M72/AS01E and developed by GlaxoSmithKline (GSK), contributed to preventing TB in 50 percent of people receiving it, representing a significant advancement towards ending the TB emergency. This would be the first new vaccine for preventing TB – the leading cause of death by infectious disease – in nearly a century. The only vaccine against TB currently available is BCG, which was developed in 1921 and does not provide proven and consistent protection in adults in TB-endemic countries.

Dr Paula I Fujiwara, Scientific Director of The Union said: “We are one more cautious, but exciting, step closer to a vaccine for TB.”

“A vaccine is the ultimate prevention tool and the announcement today is welcome news, but as researchers discuss how to move the trial into its final phase, we simultaneously need to be doing all we can to prevent TB with medications that we already have at our disposal.

“TB is a disease that is preventable, treatable and curable, yet last year it killed 1.5 million people, more than HIV/AIDS. We cannot end the TB emergency unless we dramatically scale up prevention in those parts of the world where we are treating it. The cost of inaction is more unnecessary suffering and death”, said Dr Fujiwara.

The 50th Union World Conference on Lung Health 

The Phase 2b randomised, double-blind, placebo-controlled study was conducted at 11 sites in Kenya, South Africa and Zambia, in TB endemic regions. Final analysis, conducted after 36 months of follow-up, was published in the New England Journal of Medicine and presented at TBScience 2019, as part of the 50th Union World Conference on Lung Health. Now GSK will work with partners to build an end-to-end model to further develop the candidate vaccine ensuring it is progressed diligently.

CONFERENCE NEWS


Global Tuberculosis Report 2019: Latest status of the tuberculosis epidemic

Dissemination of Findings and Recommendations of Joint External Monitoring Mission(JEMM) of Nepal National Tuberculosis Program

National Tuberculosis Programme Annual Report 2018

October 30, 2019 0 comments
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Health EquityInternational Plan, Policy & GuidelinesPublic HealthResearch & Publication

What we need to know about Health in All Policies (HiAP)?

by Public Health Update October 25, 2019
written by Public Health Update

What we need to know about Health in All Policies (HiAP)?

Health in All Policies

Helsinki Statement on Health in All Policies 2013 stated that ”Health in All Policies is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity.”– Helsinki Statement on Health in All Policies 2013; WHO (WHA67.12) 2014. Contributing to social and economic development: sustainable action across sectors to improve health and health equity.

Important Documents for Health in All Policies (HiAP)

Adelaide Statement on Health in All Policies 2010 & 2017
The Helsinki Statement on Health in All Policies 2013
What we need to know about Health in All Policies (HiAP)?

Health equity is achieved when every person has the opportunity to “attain his or her full health potential” and no one is “disadvantaged from achieving this potential because of social position or other socially determined circumstances.” To improve equity in health (including in Universal Health Coverage) it is necessary to change the underlying distribution of the role of social determinants of health.

Screen Shot 2019 10 25 at 14.35.57

 

Impacts Health in All Policies :Example

One in eight deaths is linked to air pollution exposure – mostly from heart and lung disease, and stroke. To tackle air pollution, a health ministry cannot act alone. Collaboration is needed within many sectors:

  • Household energy– works to ensure clean cooking, heating and lighting technologies are available in the home, It educates people about adopting clean fuels (liquid gas, ethanol),avoiding coal and kerosene use in the home, and cooking in areas with good ventilation.
  • Energy – works to increase use of low-emissions fuels and renewable combustion-free power sources (like solar, wind or hydropower); adopt co-generation of heat and power; and distributed energy generation (e.g. mini-grids and rooftop solar power generation). Also works to reduce reliance on wood, diesel and coal generators, and protect against deforestation, occupational risks from coal mining and fumes from combustion of dirty fuels.
  • Transport – works to prioritize urban transit, walking, cycling networks in cities so there is less reliance on vehicles. It works to shift technologies to cleaner heavy duty vehicles and low-emissions vehicles and fuels, including fuels with reduced sulfur and particle content.
  • Urban planning – works to make cities more compact, and thus energy efficient.
  • Housing – works to improve the energy efficiency of buildings through healthy and affordable construction standards.
  • Waste Management – works reduce waste through separation, recycling and reuse or waste reprocessing; as well as improved methods of biological waste management such as anaerobic waste digestion to produce biogas.
  • Industry – uses clean technologies that reduce industrial smokestack emissions and improves management of urban and agricultural waste, including capture of methane gas emitted from waste sites as an alternative to incineration (for use as biogas).
  • Health Sector – works to connect all sectors. It tracks data on air-pollution related diseases and health gains from key interventions nationally and supports the energy-sector in needs-based assessments and fuel evaluations for the energy use of disadvantaged groups. The sector also advocates for policies to introduce clean technologies and reduce fuel poverty, and adopts renewable energy sources, especially in remote areas dependent on diesel generators.
  • International – WHO sets guidelines, determines which interventions have the greatest impact, builds global databases to monitor global progress on health impact and advocates for clean air..
  • Local, Regional and Country Municipalities – works to develop policies to reduce tobacco smoking and thus second hand smoke. They also set emission rate targets, approve planning codes and housing development and grant tax incentives energy efficiency certification schemes.
  • NGOs, donors, civil society – works to provide access to improved cooking stores and helps fund initiatives for clean home energy technologies and fuels.

Overall, the health sector is the champion for health, driving dialogues to keep health on the agenda.

Why do governments/ societies need Health in All Policies?

Health in All Policies (HiAP) is based on the recognition that our greatest health challenges—for example, noncommunicable diseases, health inequities and inequalities, climate change, and spiralling health care costs—are highly complex and often linked through the social determinants of health. The social determinants of health are the circumstances in which people are born, grow up, live, work and age, and the wider set of forces and systems affecting these circumstances: e.g. economic and development policies, social norms, social policies, and political systems.

In this context, promoting healthy communities, and in particular health equity across different population groups, requires that we address the social determinants of health, such as public transportation, education access, access to healthy food, economic opportunities, and more. While many public policies work to achieve this, conflicts of interest may arise. Alternatively, unintended impacts of policies are not measured and addressed. This requires innovative solutions, and structures that build channels for dialogue and decision-making that work across traditional government policy siloes.

 

What roles do ministries of health play in HiAP?

WHO resolution WHA67.12 calls upon ministries of health ”to champion health and the promotion of health equity as a priority and take efficient action on social, economic and environmental determinants of health”. Although each country has its own political structure and forms of administration, the role of the health ministry or similar body at the national level, in relation to health in all policies usually includes work on health determinants that includes:

  • Supporting the growth of scientific knowledge on health determinants;
  • Identifying and prioritizing emerging health issues resulting from changes in society;
  • Monitoring the activities of other sectors that impact on health;
  • Creating structures and mechanisms for dialogue across government and with whole of society;
  • Facilitating negotiations between sectors and with non-government stakeholders; and
  • Overseeing the implementation, monitoring and evaluation of policy with respect to health outcomes, health determinants and equity.
Important Documents for Health in All Policies (HiAP)
  • Adelaide Statement on Health in All Policies 2010 & 2017
  • The Helsinki Statement on Health in All Policies 2013
  • What we need to know about Health in All Policies (HiAP)?
  • Health in All Policies: A Guide for State and Local Governments
  • FINAL REPORT The 1st Global Meeting of the Global Network for Health in All Policies (GNHiAP) 2017
  • Key Learning on Health in All Policies Implementation from Around the World Information Brochure
  • PRACTISING A HEALTH IN ALL POLICIES APPROACH— LESSONS FOR UNIVERSAL HEALTH COVERAGE AND HEALTH EQUITY A policy briefing for ministries of health based on experiences from Africa, South-East Asia and the Western Pacific
  • HEALTH IN ALL POLICIES TRAINING MANUAL
  • Progressing the Sustainable Development Goals through Health in All Policies: Case studies from around the world
  • Health in All Policies Toolkit – ASTHO
October 25, 2019 0 comments
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Health EquityInternational Plan, Policy & GuidelinesPublic HealthResearch & Publication

The Helsinki Statement on Health in All Policies 2013

by Public Health Update October 25, 2019
written by Public Health Update

The Helsinki Statement on Health in All Policies 2013

The 8th Global Conference on Health Promotion was held in Helsinki, Finland from 10-14 June 2013. The meeting builds upon a rich heritage of ideas, actions and evidence originally inspired by the Alma Ata Declaration on Primary Health Care (1978) and the Ottawa Charter for Health Promotion (1986). These identified intersectoral action and healthy public policy as central elements for the promotion of health, the achievement of health equity, and the realization of health as a human right. Subsequent WHO global health promotion conferences [Subsequent conferences were held in Adelaide (1988); Sundsvall (1991); Jakarta (1997); Mexico City (2000); Bangkok (2005); Nairobi (2009)]. cemented key principles for health promotion action. These principles have been reinforced in the 2011 Rio Political Declaration on Social Determinants of Health, the 2011 Political Declaration of the UN High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases, and the 2012 Rio+20 Outcome Document (the Future We Want). They are also reflected in many other WHO frameworks, strategies and resolutions, and contribute to the formulation of the post-2015 development goals.

Health for All is a major societal goal of governments, and the cornerstone of sustainable development.

The participants of this conference

  • Affirm their commitment to equity in health and recognize that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. Participant recognize that governments have a responsibility for the health of their people and that equity in health is an expression of social justice. Participant knows that good health enhances quality of life, increases capacity for learning, strengthens families and communities and improves workforce productivity. Likewise, action aimed at promoting equity significantly contributes to health, poverty reduction, social inclusion and security.
  • Health inequities between and within countries are politically, socially and economically unacceptable, as well as unfair and avoidable. Policies made in all sectors can have a profound effect on population health and health equity. In our interconnected world, health is shaped by many powerful forces, especially demographic change, rapid urbanization, climate change and globalization. While some diseases are disappearing as living conditions improve, many diseases of poverty still persist in developing countries. In many countries lifestyles and living and working environments are influenced by unrestrained marketing and subject to unsustainable production and consumption patterns. The health of the people is not only a health sector responsibility, it also embraces wider political issues such as trade and foreign policy. Tackling this requires political will to engage the whole of government in health.
  • Health in All Policies is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity. It improves accountability of policymakers for health impacts at all levels of policy-making. It includes an emphasis on the consequences of public policies on health systems, determinants of health and well-being.

  • Participants recognized that governments have a range of priorities in which health and equity do not automatically gain precedence over other policy objectives. We call on them to ensure that health considerations are transparently taken into account in policy-making, and to open up opportunities for co-benefits across sectors and society at large. Policies designed to enable people to lead healthy lives face opposition from many sides. Often they are challenged by the interests of powerful economic forces that resist regulation. Business interests and market power can affect the ability of governments and health systems to promote and protect health and respond to health needs. Health in All Policies is a practical response to these challenges.

  • It can provide a framework for regulation and practical tools that combine health, social and equity goals with economic development, and manage conflicts of interest transparently. These can support relationships with all sectors, including the private sector, to contribute positively to public health outcomes.

  • Participants saw that Health in All Policies as a constituent part of countries’ contribution to achieving the United Nations Millennium Development Goals and it must remain a key consideration in the drafting of the post-2015 Development Agenda.

The participants of this conference

  • Prioritize health and equity as a core responsibility of governments to its peoples.
  • Affirm the compelling and urgent need for effective policy coherence for health and well-being.
  • Recognize that this will require political will, courage and strategic foresight.

Participants call on governments to fulfil their obligations to their peoples’ health and well-being by taking the following actions:

  • Commit to health and health equity as a political priority by adopting the principles of Health in All Policies and taking action on the social determinants of health.
  • Ensure effective structures, processes and resources that enable implementation of the Health in All Policies approach across governments at all levels and between governments.
  • Strengthen the capacity of Ministries of Health to engage other sectors of government through leadership, partnership, advocacy and mediation to achieve improved health outcomes.
  • Build institutional capacity and skills that enable the implementation of Health in All Policies and provide evidence on the determinants of health and inequity and on effective responses.
  • Adopt transparent audit and accountability mechanisms for health and equity impacts that build trust across government and between governments and their people.
  • Establish conflict of interest measures that include effective safeguards to protect policies from distortion by commercial and vested interests and influence.
  • Include communities, social movements and civil society in the development, implementation and monitoring of Health in All Policies, building health literacy in the population.
Participants call on WHO to
  • Support Member States to put Health in All Policies into practice
  • Strengthen its own capacity in Health in All Policies
  • Use the Health in All Policies approach in working with United Nations agencies and other partners on the unfinished Millennium Development Goals agenda and the post-2015 Development Agenda
  • Urge the United Nations family, other international organizations, multilateral development banks and development agencies to achieve coherence and synergy in their work with Member States to enable implementation of Health in All Policies
The participants of this conference
  • Commit ourselves to communicate the key messages of this Helsinki Statement to our governments, institutions and communities.

The Helsinki Statement on Health in All Policies

Important Documents for Health in All Policies (HiAP)

Adelaide Statement on Health in All Policies 2010 & 2017
The Helsinki Statement on Health in All Policies 2013
What we need to know about Health in All Policies (HiAP)?

October 25, 2019 0 comments
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Health EquityInternational Plan, Policy & GuidelinesPublic HealthResearch & Publication

Adelaide Statement on Health in All Policies 2010 & 2017

by Public Health Update October 25, 2019
written by Public Health Update

Adelaide Statement on Health in All Policies 2010

Moving towards a shared governance for health and well-being

The Adelaide Statement was developed by the participants of the Health in All Policies International Meeting, Adelaide 13–15 April 2010. The Government of South Australia together with WHO invited 100 senior experts from a wide range of sectors and countries to discuss the implementation of the Health in All Policies approach. The main aim of the meeting was to move the agenda forward by identifying key principles and pathways that contribute to action for health across all sectors of government, and engage the health sector in contributing to the goals of other sectors.

The Adelaide Statement on Health in All Policies is to engage leaders and policy-makers at all levels of government—local, regional, national and international. It emphasizes that government objectives are best achieved when all sectors include health and well-being as a key component of policy development. This is because the causes of health and well-being lie outside the health sector and are socially and economically formed. Although many sectors already contribute to better health, significant gaps still exist.

The Adelaide Statement outlines the need for a new social contract between all sectors to advance human development, sustainability and equity, as well as to improve health outcomes. This requires a new form of governance where there is joined-up leadership within governments, across all sectors and between levels of government. The Statement highlights the contribution of the health sector in resolving complex problems across government.

Achieving social, economic and environmental development

A healthy population is a key requirement for the achievement of society’s goals. Reducing inequalities and the social gradient improves health and well-being for everyone. Good health enhances quality of life, improves workforce productivity, increases the capacity for learning, strengthens families and communities, supports sustainable habitats and environments, and contributes to security, poverty reduction and social inclusion. Yet escalating costs for treatment and care are placing unsustainable burdens on national and local resources such that broader developments may be held back.

This interface between health, well-being and economic development has been propelled up the political agenda of all countries. Increasingly, communities, employers and industries are expecting and demanding strong coordinated government action to tackle the determinants of health and well-being and avoid duplication and fragmentation of actions.

Need for joined-up government

The interdependence of public policy requires another approach to governance. Governments can coordinate policymaking by developing strategic plans that set out common goals, integrated responses and increased accountability across government departments. This requires a partnership with civil society and the private sector.

Since good health is a fundamental enabler and poor health is a barrier to meeting policy challenges, the health sector needs to engage systematically across government and with other sectors to address the health and well-being dimensions of their activities. The health sector can support other arms of government by actively assisting their policy development and goal attainment.

To harness health and well-being, governments need institutionalized processes which value cross-sector problem solving and address power imbalances. This includes providing the leadership, mandate, incentives, budgetary commitment and sustainable mechanisms that support government agencies to work collaboratively on integrated solutions.

Important Documents for Health in All Policies (HiAP)

Adelaide Statement on Health in All Policies 2010 & 2017
The Helsinki Statement on Health in All Policies 2013
What we need to know about Health in All Policies (HiAP)?

Health in All Policies approach

The approach described above is referred to as ‘Health in All Policies’ and has been developed and tested in a number of countries. It assists leaders and policy-makers to integrate considerations of health, well-being and equity during the development, implementation and evaluation of policies and services.

Health in All Policies works best when:

  • a clear mandate makes joined-up government an imperative;
  • systematic processes take account of interactions across sectors;
  • mediation occurs across interests;
  • accountability, transparency and participatory processes are present;
  • engagement occurs with stakeholders outside of government;
  • practical cross-sector initiatives build partnerships and trust.
Drivers for achieving Health in All Policies

Building a process for Health in All Policies requires using windows of opportunity to change mindsets and decision-making cultures, and to prompt actions. Key drivers are context specific and can include:

  • creating strong alliances and partnerships that recognize mutual interests, and share targets;
  • building a whole of government commitment by engaging the head of government, cabinet and/or parliament, as well as the administrative leadership;
  • developing strong high-level policy processes;
  • embedding responsibilities into governments’ overall strategies, goals and targets;
  • ensuring joint decision-making and accountability for outcomes;
  • enabling openness and full consultative approaches to encourage stakeholder endorsement and advocacy;
  • encouraging experimentation and innovation to find new models that integrate social, economic and environmental goals;
  • pooling intellectual resources, integrating research and sharing wisdom from the field;
  • providing feedback mechanisms so that progress is evaluated and monitored at the highest level.

It is not unusual that such a process can create tensions within government as conflicts over values and diverging interests can emerge. Resolution can be achieved through persistent and systematic engagement with political processes and key decision-makers.

New role for the health sector

To advance Health in All Policies the health sector must learn to work in partnership with other sectors. Jointly exploring policy innovation, novel mechanisms and instruments, as well as better regulatory frameworks will be imperative. This requires a health sector that is outward oriented, open to others, and equipped with the necessary knowledge, skills and mandate. This also means improving coordination and supporting champions within the health sector itself.

New responsibilities of health departments in support of a Health in All Policies approach will need to include:

  • understanding the political agendas and administrative imperatives of other sectors;
  • building the knowledge and evidence base of policy options and strategies;
  • assessing comparative health consequences of options within the policy development process;
  • creating regular platforms for dialogue and problem solving with other sectors;
  • evaluating the effectiveness of intersectoral work and integrated policy-making;
  • building capacity through better mechanisms, resources, agency support and skilled and dedicated staff;
  • working with other arms of government to achieve their goals and in so doing advance health and well-being.

Next steps in the development process

The Adelaide Statement is part of a global process to develop and strengthen a Health in All Policies approach based on equity. It contributes to a critical debate that Member States and Regions of the World Health Organization (WHO) are now engaged in. The Statement reflects the track record of countries that have already gained experience in implementing such an approach.

The Statement provides valuable input into the World Conference on Social Determinants of Health in Brazil 2011, the 8th Global Conference on Health Promotion in Finland 2013, and preparations for the Millennium Development Goals (MDGs) post-2015.

Download: Adelaide Statement on Health in All Policies. WHO, Government of South Australia, Adelaide 2010.


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A milestone for humanity: Two strains of polio are now eradicated

by Public Health Update October 25, 2019
written by Public Health Update

A milestone for humanity: Two strains of polio are now eradicated

Global eradication of wild poliovirus type 3 declared on World Polio Day

24 October 2019 (WHO)
In an historic announcement on World Polio Day, an independent commission of experts concluded that wild poliovirus type 3 (WPV3) has been eradicated worldwide. Following the eradication of smallpox and wild poliovirus type 2, this news represents a historic achievement for humanity.
“The achievement of polio eradication will be a milestone for global health. Commitment from partners and countries, coupled with innovation, means of the three wild polio serotypes, only type one remains,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization and Chair of the Global Polio Eradication Initiative (GPEI) Polio Oversight Board “We remain fully committed to ensuring that all necessary resources are made available to eradicate all poliovirus strains. We urge all our other stakeholders and partners to also stay the course until final success is achieved,” he added.

There are three individual and immunologically-distinct wild poliovirus strains: wild poliovirus type 1 (WPV1), wild poliovirus type 2 (WPV2) and wild poliovirus type 3 (WPV3). Symptomatically, all three strains are identical, in that they cause irreversible paralysis or even death. But there are genetic and virologic differences which make these three strains three separate viruses that must each be eradicated individually.

Related: Global Commission for Certification of Poliomyelitis Eradication (GCC) meet in Geneva to review criteria for certification

WPV3 is the second strain of the poliovirus to be wiped out, following the certification of the eradication of WPV2 in 2015. The last case of WPV3 was detected in northern Nigeria in 2012. Since then, the strength and reach of the eradication programme’s global surveillance system has been critical to verify that this strain is truly gone. Investments in skilled workers, innovative tools and a global network of laboratories have helped determine that no WPV3 exists anywhere in the world, apart from specimens locked in secure containment.

A milestone for humanity Two strains of polio are now eradicated 2019

A milestone for humanity- Two strains of polio are now eradicated_2019

Official Certificate received by Dr. Tedros, Director-General of the World Health Organization

Official Certificate received by Dr. Tedros, Director-General of the World Health Organization

At a celebration event at the headquarters of the World Health Organization in Geneva, Switzerland, Professor David Salisbury, chair of the independent Global Commission for the Certification of Poliomyelitis Eradication, presented the official certificate of WPV3 eradication to Dr Adhanom Ghebreyesus. “Wild poliovirus type 3 is globally eradicated,” said Professor Salisbury. “This this is a significant achievement that should reinvigorate the eradication process and provides motivation for the final step – the eradication of wild poliovirus type 1. This virus remains in circulation in just two countries: Afghanistan and Pakistan. We cannot stop our efforts now: we must eradicate all remaining strains of all polioviruses.  We do have good news from Africa:  no wild poliovirus type 1 has been detected anywhere on the continent since 2016 in the face of ever improving surveillance.  Although the region is affected by circulating vaccine-derived polioviruses, which must urgently be stopped, it does appear as if the continent is free of all wild polioviruses, a tremendous achievement.”

Related: 27th March 2014 : Historical Day in field of Public Health to end Polio in Nepal

Eradicating WPV3 proves that a polio-free world is achievable.

Key to success will be the ongoing commitment of the international development community.  To this effect, as part of a Global Health Week in Abu Dhabi, United Arab Emirates, in November 2019, the Reaching the Last Mile Forum will focus international attention on eradication of the world’s deadliest diseases and provide an opportunity for world leaders and civil society organizations, notably Rotary International which is at the origin of this effort, to contribute to the last mile of polio eradication.

Fractional Dose of Inactivated Polio Vaccine-fIPV

The GPEI 2019–2023 Investment Case lays out the impact of investing in polio eradication.  The polio eradication efforts have saved the world more than US$27 billion in health costs since 1988.A sustained polio-free world will generate further US$14 billion in savings by 2050, compared to the cost countries would incur for controlling the virus indefinitely.

WORLD HEALTH ORGANIZATION


5 Years of Polio-free WHO South-East Asia Region

One Day. One Focus: Ending Polio! #WorldPolioDay

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International Lead Poisoning Prevention Week 2019

by Public Health Update October 25, 2019
written by Public Health Update

International Lead Poisoning Prevention Week 2019

The international lead poisoning prevention week of action is observed on 20 to 26 October 2019. This action is particularly focused on eliminating lead paint.

The objectives

During the campaign week, the Global Alliance to Eliminate Lead Paint aims to:

  • Raise awareness about health effects of lead poisoning;
  • Highlight countries and partners’ efforts to prevent particularly childhood lead poisoning; and
  • Urge further action to eliminate lead paint through regulatory action at country level.

International Lead Poisoning Prevention Week raises awareness and promotes actions to address the human health effects of lead exposure, especially for children. During the week, governments, academia, industry and civil society advance efforts to prevent childhood lead poisoning, and specifically laws to eliminate lead in paint.

Picture11

International Lead Poisoning Prevention Week 2019

Picture122

International Lead Poisoning Prevention Week 2019

Statistics 

Lead poisoning is preventable, yet the Institute for Health Metrics and Evaluation has estimated that in 2017 lead exposure accounted for 1.06 million deaths and 24.4 million years lost to disability and death due to long-term effects on health, with the highest burden in developing regions. Of particular concern is the role of lead exposure in the development of intellectual disability in children. Even though there is wide recognition of this problem and many countries have taken action, exposure to lead, particularly in childhood, remains of key concern to health care providers and public health officials worldwide.

SDGs

In eliminating lead paint countries will contribute to the achievement of the following Sustainable Development Goal targets:

  • 3.9: By 2030 substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination.
  • 12.4 By 2020, achieve the environmentally sound management of chemicals and all wastes throughout their life cycle, in accordance with agreed international frameworks, and significantly reduce their release to air, water and soil in order to minimize their adverse impacts on human health and the environment.

WORLD HEALTH ORGANIZATION

#BanLeadPaint #ILPPW2019


The World Heart Federation World Congress of Cardiology

Senior Programme Officer (Nutrition & Health) – ACF | Action Against Hunger

Vacancy Announcement for Chief of Party (COP)- CARE

Senior Programme Officer (Nutrition & Health) – ACF | Action Against Hunger

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UNICEF’s latest report, The State of the World’s Children 2019

by Public Health Update October 21, 2019
written by Public Health Update

UNICEF’s latest report, The State of the World’s Children 2019

For the first time in 20 years, UNICEF’s flagship report examines the issue of children, food and nutrition, providing a fresh perspective on a rapidly evolving challenge.

This 2019 edition of The State of the World’s Children (SOWC) examines the issue of children, food and nutrition, providing a fresh perspective on a rapidly evolving challenge. Despite progress in the past two decades, one third of children under age 5 are malnourished – stunted, wasted or overweight – while two thirds are at risk of malnutrition and hidden hunger because of the poor quality of their diets. At the center of this challenge is a broken food system that fails to provide children with the diets they need to grow healthy. This report also provides new data and analyses of malnutrition in the 21st century and outlines recommendations to put children’s rights at the heart of food systems.

Key messages (Executive Summary Report)

At least 1 in 3 children under 5 is undernourished or overweight and 1 in 2 suffers from hidden hunger, undermining the capacity of millions of children to grow and develop to their full potential.

  • Globally, at least 1 in 3 children under 5 is not growing well due to malnutrition in its more visible forms: stunting, wasting and overweight.
  • Globally, at least 1 in 2 children under 5 suffers from hidden hunger due to deficiencies in vitamins and other essential nutrients.
  • Undernutrition continues to exert a heavy toll. In 2018, almost 200 million children under 5 suffered from stunting or wasting while at least 340 million suffered from hidden hunger.
  • Overweight and obesity continue to rise. From 2000–2016, the proportion of overweight children (5 to 19 years old) rose from 1 in 10 to almost 1 in 5.
  • The number of stunted children has declined in all continents, except in Africa while the number of overweight children has increased in all continents, including in Africa.
  • The triple burden of malnutrition – undernutrition, hidden hunger and overweight – threatens the survival, growth and development of children, young people, economies and nations.

The triple burden of malnutrition – undernutrition, hidden hunger and overweight – threatens the survival, growth and development of children, young people, economies and nations.

  • Stunting – a clear sign that children in a country are not developing well – is both a symptom of past deprivation and a predictor of future poverty.
  • Wasting can be lethal for children, particularly in its most severe forms. Contrary to common belief, most wasted children around the world live in Asia and not in emergency settings.
  • Hidden hunger harms children and women. Iron deficiency reduces children’s ability to learn and iron deficiency anaemia increases women’s risk of death during or shortly after childbirth.
  • Child overweight can lead to early onset of type-2 diabetes, stigmatization and depression, and is a strong predictor of adult obesity, with serious health and economic consequences.
  • The greatest burden of all forms of malnutrition is shouldered by children and young people from the poorest and most marginalized communities, perpetuating poverty across generations. Key Messages Children, food and nutrition | Growing well in a changing world A child sells snacks to other children outside a clinic in Gaza City, State of Palestine.

The triple burden of malnutrition is driven by the poor quality of children’s diets: 2 in 3 children are not fed the minimum recommended diverse diet for healthy growth and development.

  • Only 2 in 5 infants under six months of age are exclusively breastfed, as recommended. Breastfeeding could save the lives of 820,000 children annually worldwide.
  • Use of breastmilk substitutes is of concern. Sales of milk-based formula grew by 41 per cent globally and by 72 per cent in upper middle-income countries such as Brazil, China and Turkey from 2008–2013.
  • Poor diets drive malnutrition in early childhood: 44 per cent of children aged 6 to 23 months are not fed fruits or vegetables and 59 per cent are not fed eggs, dairy, fish or meat.
  • Only 1 in 5 children aged 6 to 23 months from the poorest households and rural areas is fed the minimum recommended diverse diet for healthy growth and brain development.
  • Many school-going adolescents consume highly processed foods: 42 per cent drink carbonated soft drinks at least once a day and 46 per cent eat fast food at least once a week.

 

Globalization, urbanization, inequities, humanitarian crises and climate shocks are driving unprecedented negative changes in the nutrition situation of children around the world.

  • Globalization is shaping food options and choices: 77 per cent of processed food sales worldwide are controlled by just 100 large firms.
  • In cities, many poor children live in ‘food deserts’, facing an absence of healthy food options, or in ‘food swamps’, confronted with an abundance of high-calorie, low-nutrient, processed foods.
  • Poor families tend to select low-quality food that costs less. Because of poverty and exclusion, the most disadvantaged children face the greatest risk of all forms of malnutrition.
  • Climate shocks, loss of biodiversity, and damage to water, air and soil are worsening the nutritional prospects of millions of children and young people, especially among the poor.
  • UNICEF and its partners treated more than 3.4 million children with severe malnutrition in humanitarian settings in 2018, from Afghanistan and Yemen to Nigeria and South Sudan.

 

Improving children’s nutrition requires food systems to deliver nutritious, safe, affordable and sustainable diets for all children.

  • Millions of children are eating too little of what they need, and millions are eating too much of what they don’t need: poor diets are now the main risk factor for the global burden of disease.
  • National food systems must put children’s nutrition at the heart of their work because their nutritional needs are unique and meeting them is critical for sustainable development.
  • Financial incentives should be used to reward actors who increase the availability of healthy and affordable foods in markets and other points of sale especially in low-income communities.
  • Financial disincentives on unhealthy foods can improve children’s diets. For example, taxes on sugary foods and beverages can reduce their consumption by children and adolescents.
  • Fortification of complementary foods and staple foods with micronutrients can be a cost-effective intervention to combat hidden hunger in children, young people and women.

 

Food environments are crucial. When healthy options are affordable, convenient and desirable, children and families make better food choices.

  • Children, adolescents, young people, parents and families need support to demand nutritious foods, but food environments need to promote and support healthy diets.
  • Innovative, fun, memorable and engaging communication strategies to promote healthy eating can leverage the cultural and social aspirations of children, adolescents and families.
  • Legislation plays a key role in promoting good diets for children, such as by regulating the marketing of breastmilk substitutes to mothers and families, and of unhealthy food to children.
  • The marketing of unhealthy foods and sugar sweetened beverages is directly linked to growing overweight and obesity in children.
  • Front of package labelling – visible, accurate and easy to understand – helps children, young people and families make healthier food choices and incentivizes suppliers to deliver healthy food.
  • Governments need to promote healthy food environments in schools, including healthy meals and limiting the sale and advertising of ‘junk food’ in proximity to schools and playgrounds.
  • The health, water and sanitation, education and social protection systems also have crucial roles to play in promoting and supporting good nutrition for children, adolescents and women. Investing in nutrition for children and young people is a cornerstone investment if the world is to achieve the Sustainable Development Goals by 2030.

 

Investing in child nutrition is key to human capital formation because nutrition is central to children’s growth, cognitive development, school performance and future productivity.

  • A large and young labour force – with a great creativity and productivity potential – is emerging in Africa and Asia. However, malnutrition risks limiting this demographic dividend.
  • Returns from investment in nutrition are high. For example, every dollar invested in reducing stunting generates an economic return equivalent to about US$18 in high-burden countries.

 

One word must be at the heart of our response to children’s malnutrition – action. We need action that reflects the core role of food systems, that strengthens the supply of – and demand for – better food, that improves children’s food environments, and leverages the role of key supportive systems. With action comes another imperative: accountability. Progress must be measured, shared, acted on and celebrated. Sound nutrition is fundamental to children’s well-being and the achievement of the Sustainable Development Goals. It needs to be put at the heart of government policy and supported by key stakeholders, including civil society and the private sector.

The State of the World’s Children 2019 report concludes with the following Agenda to Put Children’s Nutrition Rights First:

  1. Empower families, children and young people to demand nutritious food.
  2. Drive food suppliers to do the right thing for children.
  3. Build healthy food environments for all children.
  4. Mobilize supportive systems – health, water and sanitation, education and social protection – to scale up nutrition results for all children.
  5. Collect, analyse and use good-quality data and evidence regularly to guide action and track progress.

DOWNLOAD: EXECUTIVE SUMMARY REPORTFULL REPORT


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7th Annual Feed the Future Innovation Lab for Nutrition Scientific Symposium on Agriculture

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