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COP28 UAE Climate and Health Declaration
Environmental Health & Climate ChangeGlobal Health NewsPublic Health NewsPublic Health UpdateWorld News

COP28 UAE Climate and Health Declaration: Putting Health at the Heart of the Climate Agenda

by Public Health Update December 2, 2023
written by Public Health Update

Historic Focus on Climate Health Impacts

The ‘Putting Health at the Center of Climate Agenda’ session of the World Climate Action Summit on 2nd December, combined multiple transformative climate health announcements to drive down emissions and protect health globally. Announcements included the unveiling of the Climate and Health Declaration, climate health financing from partners, and transformative Guiding Principles for Financing Climate and Health Solutions established to protect health.

The First Health Day at a COP

Climate change is one of the greatest threats to human health in the 21st century. COP28 will be the first COP to host a Health Day and climateministerial at a COP on December 3rd. At the first ever Health Day, participants will progress solutions to reduce carbon emissions, limiting air pollution, and preventing premature deaths.

Global Action to Address Climate Health Impacts

  • Endorsements from 123 countries for COP28 UAE’s Climate and Health Declaration
  • 41 endorsements from key partners of the Guiding Principles for Financing Climate and Health Solutions
  • Funders announce over $1bn funding to address the climate health crisis.

COP28 UAE Declaration on Climate and Health

We, on the occasion of the first Health Day at the 28th UN Climate Change Conference (COP28), express our grave concern about the negative impacts of climate change on health. We stress the importance of addressing the interactions between climate change and human health and wellbeing in the context of the UNFCCC and the Paris Agreement, as the primary international, intergovernmental fora for the global response to climate change.

We recognize the urgency of taking action on climate change, and note the benefits for health from deep, rapid, and sustained reductions in greenhouse gas emissions, including from just transitions, lower air pollution, active mobility, and shifts to sustainable healthy diets.

In this year of the first Global Stocktake, and given the lessons learned from the COVID-19 pandemic, which
strained all health systems and further widened inequities and vulnerabilities within and among countries,
regions and populations, we are committed to the advancement of climate-resilient development, the
strengthening of health systems, and the building of resilient and thriving communities, for the benefit of
present and future generations.

In order to work towards ensuring better health outcomes, including through the transformation of health systems to be climate-resilient, low-carbon, sustainable and equitable, and to better prepare communities and the most vulnerable populations for the impacts of climate change, we commit to pursuing the following common objectives:

  • Strengthening the development and implementation of policies that maximize the health gains from mitigation and adaptation actions and prevent worsening health impacts from climate change, including through close partnerships with Indigenous Peoples, local communities, women and girls, children and youth, healthcare workers and practitioners, persons with disabilities and the populations most vulnerable to the health impacts of climate change, among others.
  • Facilitating collaboration on human, animal, environment and climate health challenges, such as by implementing a One Health approach; addressing the environmental determinants of health; strengthening research on the linkages between environmental and climatic factors and antimicrobial resistance; and intensifying efforts for the early detection of zoonotic spill-overs as an effective means of pandemic prevention, preparedness and response.
  • Recognizing that healthy populations contribute to, and are an effect of, climate resilience and an outcome of successful adaptation across a range of sectors – including food and agriculture, water and sanitation, housing, urban planning, health care, transport and energy – by prioritizing and implementing adaptation actions across sectors that deliver positive health outcomes.
  • Improving the ability of health systems to anticipate, and implement adaptation interventions against, climate sensitive disease and health risks, including by bolstering climate-health information services, surveillance, early warning and response systems and a climate-ready health workforce.
  • Promoting a comprehensive response to address the impacts of climate change on health, including, for example, mental health and psychosocial wellbeing, loss of traditional medicinal knowledge, loss of livelihoods and culture, and climate-induced displacement and migration.
  • Combating inequalities within and among countries, and pursuing policies that work towards accelerating achievement of the Sustainable Development Goals, including SDG3; reduce poverty and hunger; improve health and livelihoods; strengthen social protection systems, food security and improved nutrition, access to clean sources of energy, safe drinking water, and sanitation and hygiene for all; and work to achieve
  • universal health coverage.
  • Promoting steps to curb emissions and reduce waste in the health sector, such as by assessing the greenhouse gas emissions of health systems, and developing action plans, nationally determined decarbonization targets, and procurement standards for national health systems, including supply chains.
  • Strengthening trans- and inter-disciplinary research, cross-sectoral collaboration, sharing of best practices, and monitoring of progress at the climate-health nexus, including through initiatives such as the Alliance for Transformative Action on Climate and Health (ATACH).

Recognizing that health actors face challenges in accessing finance for health and climate change activities, particularly in low- and middle-income countries, we underscore the need to better leverage synergies at the intersection of climate change and health to improve the efficiency and effectiveness of finance flows.

  • Encouraging the scaling up of investments in climate and health from domestic budgets, multilateral development banks, multilateral climate funds, health financing institutions, philanthropies, bilateral development agencies, and private sector actors.
  • Encouraging international finance providers, including development banks, to strengthen the synergies between their climate and health portfolios, and enhance their support for country-led projects and programs in the health-climate nexus.
  • Sharing learnings and best practices on financing and implementing climate-health interventions, and develop a common understanding of existing needs for climate-health finance, grounded in country priorities and needs. We welcome ongoing efforts in this regard, including by the COP28 presidency, the ATACH finance working group, and the joint Development Bank working group for climate-health financing.
  • Improving monitoring, transparency and evaluation efforts of climate finance, as relevant, including for climate health initiatives, in order to strengthen common understanding of its efficiency and effectiveness, and to maximize the delivery of positive health outcomes.

To achieve these aims – according to our national circumstances – we commit to pursuing the better integration of health considerations into our climate policy processes, and of climate considerations across our health policy agendas, including by:

  • Incorporating health considerations in the context of relevant Paris Agreement and UNFCCC processes, with a view to minimizing adverse effects on public health, and mainstreaming climate considerations in global health work programs, including those of the World Health Organization, where relevant and appropriate.
  • Taking health into account, as appropriate, in designing the next round of nationally determined contributions, long term low greenhouse gas emission development strategies, national adaptation plans and adaptation communications.

We commit to convene regularly with diverse line-ministries and stakeholders to foster synergies and strengthen national and multilateral collaboration on climate change and health, including through the ATACH initiative. We will review our collective progress at future UN Climate Change Conferences, World Health Assemblies, and other global convenings.


  • Guiding Principles for Financing Climate and Health Solutions
  • Global health community calls for urgent action on climate and health at COP28
  • COP28 UAE Climate and Health Declaration: Putting Health at the Heart of the Climate Agenda
  • COP28 UAE Climate and Health Declaration: Putting Health at the Heart of the Climate Agenda
  • Guiding Principles for Financing Climate and Health Solutions
  • Global health community calls for urgent action on climate and health at COP28
  • COP28: Summary of the initiatives and financial commitments for climate and health
December 2, 2023 0 comments
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Guiding Principles for Financing Climate and Health Solutions
Environmental Health & Climate ChangeGlobal Health NewsPublic HealthPublic Health NewsPublic Health UpdateWorld News

Guiding Principles for Financing Climate and Health Solutions

by Public Health Update December 2, 2023
written by Public Health Update

41 funders, partners endorse new guiding principles for financing climate and health solutions to protect health

Guiding Principles respond to low- and middle-income countries’ calls to mobilize finance to save lives now and in the future as the climate crisis threatens global health.

A consortium of multilateral development banks and funders, countries and philanthropies today published the Guiding Principles for Financing Climate and Health Solutions(“Guiding Principles”), announced at the World Climate Action Summit during the 28th session of Conference of Parties to the UNFCCC (COP28) in Dubai.

The Guiding Principles were developed by the COP28 Presidency in partnership with the Global Fund to Fight AIDS, Tuberculosis, and Malaria, the Green Climate Fund, The Rockefeller Foundation, and the World Health Organization, and in consultation with country partners, financing institutions, private sector partners, and civil society organizations.

Guiding Principles for Financing Climate and Health Solutions

Climate change is one of the greatest health challenges of our time. It is destabilizing health systems, deepening inequities, undermining the social, environmental, and economic foundations of good health, and, ultimately, threatens the lives, health, and wellbeing of communities around the world. The Intergovernmental Panel on Climate Change estimates that 3.3 billion people worldwide are highly vulnerable to climate change and face greater health risks as a result. There are profound inequities in the burden of climate health risks and impacts, in the ability to adapt to climate change, and in access to finance, with low- and middle-income countries and vulnerable and marginalized communities most deeply affected.

It is imperative that we protect people from the harmful health impacts of climate change by pursuing ambitious mitigation and adaptation goals, preventing the worst climate risks, and building climate resilient communities including critical water, food, and health systems, in line with the Paris Agreement and the “right to health” acknowledged within it. Insufficient, fragmented, and inaccessible financing currently jeopardizes such action.

There are opportunities across sectors from health and energy systems to economic development, agriculture, gender, and beyond to advance climate and health solutions. Financing partners including development banks, multilateral funds, national governments, philanthropies, and the private sector, play a key role in each of these spaces and thus have a tremendous opportunity to safeguard human health through coordinated action in partnership with countries and communities.

In recognition of the vital need for financing to prevent and protect against the health risks of climate change, and in alignment with the Addis Ababa Action Agenda, Paris Agreement, and 2030 Agenda for Sustainable Development, and wider efforts to improve the efficiency, effectiveness and equity of financing for health and for climate, we support the following guiding principles for financing climate and health solutions:

Accelerate transformative climate and health solutions to save and improve lives now and in the future.

Early action is essential to address existing health burdens and frailties in health systems, and to curtail emissions to avoid worsening climate risks and the surpassing of adaptation limits. Priority areas include: Rapidly reduce greenhouse gas emissions to improve health, including through rapid transitions away from fossil fuels, lower air pollution, active mobility, shifts to sustainable diets, and limiting climate change. Implement proactive public health and adaptation measures to build healthy, resilient,adapted communities and protect people from the range of climate risks to health, with an emphasis on the most impacted communities. Build stronger, resilient, and environmentally sustainable health systems, including by delivering universal health coverage and high-quality care to all in a changing climate, enhancing the sector’s preparedness and adaptive capacity, and aligning the sector with global climate ambition by reducing the climate footprint of the health sector.

Support the health and climate priorities of the most impacted countries and communities

as identified in country-led plans and through partnership with communities, civil society, academia, and local governments. Elevate country ownership and leadership including through support to countries to develop and integrate climate health strategies within national plans and policies. Collaborate with countries to support resource mobilization and leverage national and international finance for climate and health solutions, respecting countries’ differentiated needs and contexts.

Promote an inclusive and equitable approach to financing climate and health solutions.

Meaningfully engage communities and civil society partners in the co-design, development, implementation, and monitoring of finance. Focus resources in the most vulnerable and impacted communities and invest directly in civil society and community-led solutions.

Mobilize a suite of financing from all partners.

Ensure the development of sustainable, resilient, and adaptive systems that can develop and deliver on climate and health plans. Enable the human, technological, social, and other resources needed to ensure the long-term impact of investments in climate and health solutions.

Embed climate and health goals across financing strategies.

targeting finance towards solutions with the greatest positive impact on human lives and wellbeing, based on evidence. Consider the health impacts of climate mitigation and adaptation in all sectors to prioritize solutions that promote health and avoid maladaptation or the deepening of health risks. Leverage health finance to advance climate mitigation and adaptation in the health sector. Maximize the climate and health gains of investments to support efficiencies in light of resource and fiscal constraints.

Enhance equitable access to finance.

including through simplified processes that are coherent, transparent, and predictable, and that increase the accessibility, effectiveness, and speed of finance, while continuing to uphold robust fiduciary, environmental, and social safeguards.

Support holistic approaches.

that address compounding climate, health, and development challenges in integrated, not isolated, ways. Foster dialogue and partnership between diverse health and climate stakeholders, including multi-sector financing institutions, to optimally use resources for large-scale impact.

Support innovation and scientific research and development.

Close the gaps on evidence-based and scalable solutions and accelerate the deployment of proven, locally appropriate best practices. Coordinate across sectors to expand climate and health solutions and evaluate their impact, recognizing the urgent need to take early and transformative action.

Promote the alignment of financing for climate and health solutions with broader efforts to transform the international financing system.

including by enabling fiscal reform and promoting the move away from subsidies that are harmful for health and the environment.

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  • COP28 UAE Climate and Health Declaration: Putting Health at the Heart of the Climate Agenda
    Date
    December 2, 2023
  • COP28: Summary of the initiatives and financial commitments for climate and health
    Date
    December 2, 2023
  • Global health community calls for urgent action on climate and health at COP28
    Date
    December 2, 2023

  • COP28 UAE Climate and Health Declaration: Putting Health at the Heart of the Climate Agenda
  • Guiding Principles for Financing Climate and Health Solutions
  • Global health community calls for urgent action on climate and health at COP28
  • COP28: Summary of the initiatives and financial commitments for climate and health
December 2, 2023 0 comments
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COP28
Environmental Health & Climate ChangeGlobal Health NewsPublic Health NewsPublic Health UpdateWorld News

Global health community calls for urgent action on climate and health at COP28

by Public Health Update December 2, 2023
written by Public Health Update

In the run-up to COP28, the World Health Organization (WHO) together with the global health community, is raising its voice to ensure that the impact of climate change on health takes centre stage in the negotiations. It is imperative to broaden the focus to human health in global discussions, leaving no room for excuses, and compelling negotiators to recognize that they bear the responsibility for the well-being of our most invaluable asset: the health of populations worldwide.

“Prioritizing health is not just a choice; it is the foundation of resilient societies,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Leaders must deliver in Dubai, providing the strong health outcomes their peoples expect and their economies urgently need. We must change the conversation and demonstrate the massive benefits of bolder climate action on our health and well-being.”

The extreme weather events around the world in recent months offer a terrifying glimpse of what lies ahead in a rapidly heating world. The IPCC report says about 3.5 billion people – nearly half of humanity – live in areas highly vulnerable to climate change. Heat-related deaths among those aged over 65 years have risen by 70% worldwide in two decades, according to WHO’s figures. Only a dramatic and dedicated effort to limit warming to 1.5 °C will prevent a future much worse than what we see now.

Increasingly frequent and severe extreme weather events, such as droughts, floods and heatwaves, will also strain healthcare infrastructure. Last year’s floods in Pakistan displaced 8 million people and affected 33 million overall. Forecasts from the World Bank indicate that without bold and immediate action, climate change could displace approximately 216 million people by 2050.

As the climate crisis jeopardizes lives and livelihoods, global food systems struggle to sustain a growing population, and compromised water sources compound the challenges. In parallel, climate change is catalyzing a surge in infectious diseases like dengue and cholera, endangering millions. Now is the time for decisive and collaborative action to mitigate the health impacts of the climate crisis and build a sustainable future for all.

As climate change poses an unprecedented challenge to health systems worldwide, it is also imperative that we strengthen our systems to be resilient, low carbon and sustainable. Failure to act swiftly will render health systems worldwide vulnerable to the overwhelming impacts of climate change.

Climate change is not a distant threat; it is a present danger affecting our health on multiple fronts. The health community asserts that climate change is already affecting our health, contributing to the spread of infectious diseases and vector-borne illnesses. There is an urgent need for negotiators to comprehend that climate change is a direct threat to global health that can no longer be ignored or downplayed.

Adapting our health systems means upgrading key interventions such as vector control, epidemiological surveillance, and access to safe water and sanitation. Additionally, the training of health staff is crucial, and support is needed to align health systems with the guidance included in WHO’s operational framework for building climate resilient and low carbon health systems.

To reduce the negative impact on health, the health community stresses the importance of reducing and stopping emissions. According to WHO, 7 million premature deaths annually are attributed to air pollution. Urgent mitigation measures, including transitioning to clean energy sources, are necessary to protect human health and create sustainable outcomes.

The health community recognizes the role health systems play in contributing to emissions, and advocates for greening the health sector. This involves decarbonizing health systems, digitalizing medicine and implementing sustainable practices in hospitals and health-care facilities to significantly reduce the 5% global emissions attributed to the health sector.

Over 1 billion people worldwide are served by health-care facilities with unreliable electricity or no electricity at all. For low-income countries lacking access to electricity, the health community calls for an acceleration of access to clean energy. WHO is working with partners to accelerate electrification of health-care facilities through renewable energies and to harmonize medical supplies and lead a transformative change towards cleaner energy sources, better services and reduced reliance on diesel and gas.

Recognizing the financial disparity in health systems

Acknowledging the financial gap in health systems, the health community calls for increased financing from new sources. The plea is to divest from and end subsidies for fossil fuels, and to mobilize new funds to support health systems in coping with climate change.

The WHO-led Alliance for Transformative Action on Climate and Health (ATACH) is dedicated to realizing the goals set at COP26 by leveraging the collective influence of WHO Member States and stakeholders to advance climate-resilient health systems. ATACH also focuses on identifying financing needs.

With the health sector grappling with unprecedented challenges, it is imperative to address the glaring disparity in financial support. Currently, the sector receives a mere 0.5% of global climate financing. To effectively confront the many challenges ahead – from the ongoing global health crisis to the ever-evolving landscape of medical research and technological advancements – a substantial increase in resources is not only warranted but essential. By multiplying financial support, we can strengthen the sector’s ability to innovate, adapt and provide optimal care, ensuring a resilient healthcare infrastructure for the challenges of today and the uncertainties of tomorrow.

WHO urgent call for climate and health action at COP28

As the world unites at COP28, the health community calls for decisive action. We urge negotiators to recognize that climate action is health action, and failure to address this reality will have profound consequences for the well-being of current and future generations.

The WHO call to action unites the health community in demanding a commitment to building resilient health systems, reducing emissions, and prioritizing health. The first-ever Health Day is set to elevate the global profile of the climate and health nexus and integrate health within the climate change agenda.

Health Day and Ministerial session

The first-ever Health Day is set to elevate the global profile of the climate and health nexus and integrate health within the climate change agenda. For the very first time, a record number of health ministers will be attending COP28. The presence of a significant number of health ministers underscores the commitment to prioritize health in the context of climate discussions and reinforces our commitment to creating a healthier and more sustainable future. The Ministerial session promises to amplify the urgency for action by bringing together global leaders to implement sustainable solutions. This historic gathering will focus on addressing the crucial intersection of health and climate change.

The legacy of COP 28 will be a commitment to a healthier planet, where the health arguments for climate action are not just heard but lead to tangible results.

News release/WHO

December 2, 2023 0 comments
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Asia Pacific Forum on Sustainable Development (APFSD) Youth Forum 2024
Grants and Funding OpportunitiesInternational Jobs & OpportunitiesOpportunities by RegionPublic Health OpportunitiesPublic Health Opportunity

Asia Pacific Forum on Sustainable Development (APFSD) Youth Forum 2024

by Public Health Update November 29, 2023
written by Public Health Update

The Asia Pacific Forum on Sustainable Development (APFSD) Youth Forum 2024 will be organised ahead of APFSD 2024 by co-conveners, Asian-Pacific Resource & Research Centre for Women (ARROW), Youth LEAD, and Y-PEER Asia Pacific Centre in partnership with the Right Here Right Now Global Partnership, Asia Pacific Regional CSOs Engagement Mechanism (APRCEM) and United Nations Economic and Social Commission for Asia and the Pacific (UN ESCAP), and in co-collaboration with the Major Group for Children and Youth, and the Children and Youth Major Group to UNEP.

This year, the Youth Forum will be held in a hybrid modality from February 15–17, 2024, with the theme, “Reinforcing the 2030 Agenda for Sustainable Development and eradicating poverty in times of multiple crises: The effective delivery of sustainable, resilient and innovative solutions with young people at the forefront.” The forum will bring together youth-led and youth-serving organisations representing adolescents and youth in all their diversities under the age of 30 to discuss and deliberate on the theme of the 11th APFSD.

The forum aims to:

  • Ensure young people’s voices and their realities are included in setting the regional agenda on sustainable development through the development of the Regional Youth Call to Action;
  • Empower young people through meaningful interactions and conversations between various stakeholders, including UN agencies, Member States, and youth-led and youth-serving organisations, to realise the commitments around the SDGs;
  • Approach the sustainable development agenda with an intersectional, youth, human rights, and justice lens to address systemic and structural issues affecting the realisation of the SDGs in the region;
  • Create a platform for young people for learning, sharing, capacity strengthening, and meaningful engagement;
  • Review the previous AFPSD Regional Youth Declaration and push forward advocacy at the national level.

Key cluster goals under discussion include SDG 1 (No poverty), SDG 2 (Zero hunger), SDG 13 (Climate action), SDG 16 (Peace, justice and strong institutions), and SDG 17 (Partnerships for the Goals).

APPLICATION IS OPEN TO THOSE WHO ARE:

  • Between 13 and 30 years of age.
  • Is progressive and believes in human rights-based approaches.
  • Demonstrates unique strengths in the application that are relevant to the SDGs under review as part of the 11th APFSD.
  • Shows understanding of SDGs at the country or regional level.
  • Individuals from marginalised or socially excluded groups, communities, and applications from far-to-reach places will be prioritised to ensure diversity and inclusion in participation at the APFSD Youth Forum.
  • Considerations will also be given to the individuals who have been part of previous APFSD Youth Forums, contributed to previous APFSD Call to Action, or have attended the intergovernmental APFSD in the past.

IMPORTANT NOTES:

  • Application deadline: 31 December 2022 (12 Midnight, Thailand time)
  • Please mention if you require interpretation services or have accessibility needs in the application form. Conveners of the Youth Forum will try and accommodate your request to the best of our ability.
  • If you are below 18 and you are selected to participate in the Youth Forum, you will be requested to provide consent from your parent/guardian in the later processes.
  • If you have any questions, contact us at apfsdyouthforum@arrow.org.my.

Application link

November 29, 2023 0 comments
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Nepal Health Facts Sheet 2023
Public Health

Nepal Health Facts Sheet 2023

by Public Health Update November 23, 2023
written by Public Health Update

The Nepal Health Facts Sheet 2023 presents the key achievements of health programs in the fiscal year 2079/80. The report highlights key milestones, providing a condensed narrative of the progression of the health sector in Nepal.

DOWNLOAD PDF FILE

DOWNLOAD PDF FILE


  • Progress of Health and Population Sector 2022/23 (2079/80 BS)
  • Progress of the Health and Population Sector, 2019/20
  • Progress of the Health and Population Sector, 2020/21 (NJAR Report)
  • Annual Report of the Department of Health Services (DoHS) 2077/78 (2020/2021)
  • Nepal Health Sector Strategy (NHSS) Mid Term Review Report
  • Preliminary Findings: Nepal Health Facility Survey 2021
November 23, 2023 0 comments
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Progress of Health and Population Sector 2022/23 (2079/80 BS)
Health SystemsPublic HealthReportsResearch & Publication

Progress of Health and Population Sector 2022/23 (2079/80 BS)

by Public Health Update November 23, 2023
written by Public Health Update

National Joint Annual Review (JAR) Report

The National Joint Annual Review (JAR) Report highlights major progress of health and population sector against the NHSS priority interventions under each of the nine outcomes over the NHSS implementation period (2015/16- 2022/23) including the last fiscal year 2022/23.

The report also presents progress against the action points of the last NJAR, and health related action points of policy and programme and Budget Speech. It summarises lessons learnt and suggests the way forward in alignment with the strategic objectives of the new sectoral strategic plan 2023-2030, endorsed in June 2023. The primary objective of this report is to inform the discussions during the NJAR 2023.

Summary will be updated soon.

Download PDF

Download PDF


Recommended readings

  • Nepal Health Facts Sheet 2023
  • Progress of the Health and Population Sector, 2019/20
  • Progress of the Health and Population Sector, 2020/21 (NJAR Report)
  • Annual Report of the Department of Health Services (DoHS) 2077/78 (2020/2021)
  • Nepal Health Sector Strategy (NHSS) Mid Term Review Report
  • Preliminary Findings: Nepal Health Facility Survey 2021
November 23, 2023 0 comments
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National Antimicrobial Treatment Guidelines 2023
Antimicrobial Resistance (AMR)National Plan, Policy & GuidelinesPublic Health UpdateResearch & Publication

National Antimicrobial Treatment Guidelines 2023

by Public Health Update November 21, 2023
written by Public Health Update

Overview

The Ministry of Health and Population (MoHP) Nepal has released new guidelines on the National Antimicrobial Treatment Guidelines 2023. The National Antibiotic Treatment Guideline was initially released by the MoHP in 2014.

National Antibiotic Treatment Guideline-2014

The new guidelines aimed to address the emergence and spread of resistance, optimize the use of available antimicrobial agents, reduce selection pressure through appropriate control measures, change the behavior of prescribers and communities to ensure rational use, and combat AMR through nationally coordinated efforts. The updated version of the National Antimicrobial Treatment Guidelines aims to provide prescribers with the necessary guidance on selecting the right drug, dose, and duration for commonly encountered infectious conditions in Nepal.

The document incorporates the cumulative antibiogram from national AMR surveillance data, considers the availability and affordability of drugs in Nepal, references the National List of Essential Medicines (NLEM), and consults other national and international protocols and guidelines. Efforts have been made to prioritize antibiotics from the “Access” group (as per the WHO AWaRe Classification of antibiotics) as the first-line therapy whenever possible. It should be noted that this document adopts the WHO’s AWaRe classification.

Scope of the guideline

  • This document provides information to healthcare workers on the rational use of antibiotics for empirical or definitive treatment of commonly encountered infections in Nepal, as well as various prophylactic measures. However, it is not exhaustive and excludes infections for which national treatment protocols already exist.
  • This document will be regularly updated as new data becomes available.

Objectives

  • To offer guidance for the optimal use of antimicrobials in various infectious conditions and for prophylactic purposes, taking into account the cumulative antibiogram from National AMR surveillance.
  • To promote the preferential use of antimicrobials from the “Access” group, while ensuring judicious use of those from the “Watch” and “Reserve” groups.
Screen Shot 2023 11 21 at 20.36.50
Antimicrobial Stewardship
General Principles

Empirical Therapy – Antibiotic treatment is considered empirical when it is administered in the absence of microbiological confirmation or while awaiting pending reports. Reevaluation of empirical antibiotics must be conducted after 48-72 hours and once the reports become available.

Important considerations

Determine if antibiotic therapy is necessary. Discontinue if the cause is determined to be non-infectious. Seek assistance
from the Antimicrobial Stewardship (AMS) team within the institution, if available.
Evaluate the possibility of using a narrow-spectrum antibiotic based on the reports. Consider de-escalating the antibiotics based on the clinical condition and available reports.

  • Assess if switching to monotherapy is appropriate (if initially using a combination).
  • Evaluate the feasibility of changing the route of administration to oral.
  • Adjust the dosage based on renal and hepatic functions, if necessary.
  • Check for potential drug interactions with other medications being used.
  • Determine if any laboratory parameters need monitoring during therapy.

These recommendations serve as a treatment guide and do not replace the clinical judgment of the responsible physician after a comprehensive assessment of each individual case.

Prescriptions should clearly include

  • Indication for antibiotic use.
  • Formulation; Capsule/Tablet or Injection.
  • Route of administration (e.g., IM or IV), infusion rate for IV, and dosing.
  • Start date, review date, stop date, or duration.

Consider implementing transmission-based precautions and isolation for patients with infectious diseases and drugresistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), drug-resistant tuberculosis (DRTB), Clostridioides difficile, etc.

Precautions to observe

  • Standard precautions: Practice proper hand hygiene, respiratory hygiene, sharps safety, safe injection practices, use sterile instruments and devices, maintain clean and disinfected environmental surfaces, and use gloves and protective clothings. Use mouth, nose, and eye protection during procedures.
  • Contact precautions: Ensure appropriate patient placement, limit patient transport, use disposable or dedicated equipment, perform cleaning and disinfection of the room, and use gloves gown.
  • Droplet precautions: Have patients wear masks for source control, ensure appropriate patient placement, limit patient transport, and provide masks for healthcare personnel.
  • Airborne precautions: Ensure patients wear masks for source control, place them in isolation rooms, limit patient transport, restrict susceptible healthcare personnel from entering the room, and have healthcare personnel wear N-95 masks or higher level respirators.

Please note that these precautions are subject to local guidelines and protocols and may require additional measures based on the specific circumstances.

Download: National Antimicrobial Treatment Guidelines 2023

Download: National Antimicrobial Treatment Guidelines 2023


  • Health Reform Manual: Eight Practical Steps
  • Global Hepatitis Report 2026
  • World Malaria Day 2026 | Driven to End Malaria: Now We Can. Now We Must.
  • International Wellness Day: Promoting Global Wellness for All
  • Summit Declaration: The 12th National Summit of Health and Population Scientists in Nepal
November 21, 2023 0 comments
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Cervical Cancer Elimination Day of Action 2023
Global Health NewsNon- Communicable Diseases (NCDs)PH Important DayPublic Health NewsPublic Health UpdateWorld News

Cervical Cancer Elimination Day of Action 2023: Marking the Third Year of the Cervical Cancer Elimination Effort

by Public Health Update November 18, 2023
written by Public Health Update

On November 17, the WHO and stakeholders commemorate the anniversary of a historic global movement, marking the commitment of the world to eliminate a cancer.

Cervical Cancer Elimination Day of Action 2023: Marking the Third Year of the Cervical Cancer Elimination Effort.
– By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia

As of 2020, the SEA Region accounted for a substantial portion of the global cervical cancer burden, with 200,000 new cases (32% of the global burden) and 100,000 deaths (34% of global fatalities), according to Global Cancer Observatory 2020. The global strategy for elimination was launched by the World Health Organization (WHO) in November 2020. Since the launch of the global strategy, Member States have demonstrated commendable political will, exemplified by the formulation and launch of elimination strategies at national level. The Interim targets within the three key pillars of the strategy are promising, viz:

  • HPV Vaccination Coverage: 90% of girls have been fully vaccinated with the HPV vaccine by age 15.
  • Screening: 70% of women have undergone high-performance testing by age 35, with a repeat screening by age 45.
  • Access to Treatment: 90% of women with precancerous conditions receive timely treatment, and 90% of women diagnosed with invasive cancer are effectively managed.

Member States have made remarkable progress in preventing, screening, and managing cervical cancer. Under the Flagship Priority of “Prevention and control of noncommunicable diseases through multisectoral policies and plans, with a focus on best buys,” cervical cancer prevention is one of the ‘best buys.’

Over the past three years, the South-East Asia Region has achieved several milestones in the elimination roadmap, marked by the development and implementation of strategic frameworks as

  • Regional Implementation Framework: A comprehensive plan for cervical cancer elimination as a public health problem covering the period 2021-2030.
  • Regional Vaccine Action Plan: Encompassing the years 2022–2030.
  • NCD Implementation Roadmap: Covering the period 2022-2030.
  • Regional Strategic Framework: Accelerating universal access to sexual and reproductive health for 2020–2024.

The SEA Region is among the pioneers in creating an implementation framework aligned with the global strategy for eliminating cervical cancer.

As of today, six Member States of the Region have introduced the HPV vaccine nationwide (Bhutan, Indonesia, Maldives, Myanmar, Sri Lanka and Thailand), two Member States (India in Sikkim State and Bangladesh in Dhaka Division) have introduced it at sub-national level,  two have planned introduction of the vaccine in 2023-24 (Nepal and Timor-Leste) while one (India) has plans to increase the scope of HPV vaccination by expanding its use to additional states. The coverage of HPV vaccination among the target girls in Bhutan has been high since 2017. Some of the other countries in the Region that faced challenges of HPV vaccine rollout during the COVID-19 pandemic are organizing catch-up vaccinations. Further, the WHO recommendation on one-dose schedule of HPV vaccination as an alternative to the two-dose schedule has been adopted by some Member States in the region.

On screening, ten out of 11 Member States reported national population-based screening programs, with nine providing early detection services at the primary health care level. Progress has been made in adopting HPV DNA screening, with Bhutan and Thailand leading in its utilization. However, achieving the 70% target by 2030 requires sustained efforts. However, a positive development is that screening has been included in essential service packages or UHC packages in several Member States.

Several Member States have established centers for managing cervical precancerous lesions, including colposcopy and thermal ablation methods. WHO support has played a pivotal role in capacity building and establishing treatment facilities. In 2022-23, WHO supported Timor-Leste in setting up the first-ever facility for treating precancerous lesions (Colposcopy and Thermal ablation) in the national hospital and expanding to three more colposcopy centers with thermal ablations. Bhutan and Myanmar were also supported in the expansion of these facilities.

Ten Member States in the region have tertiary-level cancer care. Pathology services for cancer diagnosis, chemotherapy and cancer surgeries are also available in ten countries. Nine countries have services for radiation therapy. With the aim of accelerating the scaling up of treatment services for invasive cancers, SEARO has established the South-East Asia Cancer Grid (SEACanGrid), which facilitates leveraging the strengths of one institution in building capacity of another across countries. Primary health care and community-based palliative care is expanding in the region, with exemplary initiatives in Bhutan, India and Sri Lanka. Population-based cancer registries are operational and being strengthened in eight Member States.

Ensuring all women have access to affordable and effective cervical cancer prevention and management services remains a priority. While ten out of 11 Member States report having pathology services for cancer diagnosis, cancer treatment facilities at tertiary levels, including surgical, chemotherapy, and radiotherapy services, are not universally accessible, especially among socioeconomically disadvantaged groups. To address this, a robust health system through Universal Health Coverage is imperative, ensuring services are available without causing catastrophic expenditure to beneficiaries.

Despite setbacks caused by the COVID-19 pandemic, efforts to resume and strengthen HPV vaccination and cervical cancer screening programs are underway.

It is crucial to emphasize that cervical cancer is a preventable and curable disease if detected early and treated adequately. The commitment and support of Member States extended during the Regional Committee meetings of WHO-SEARO to the global cervical cancer elimination initiative is unwavering, as demonstrated by dedicated discussions and agenda items during Regional Committee meetings held in 2019 and 2022.

Let us continue our collaborative efforts, navigate challenges, and propel the region towards the shared goal of eliminating cervical cancer.


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November 18, 2023 0 comments
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World AMR Awareness Week
Global Health NewsOutbreak NewsPH Important DayPublic Health NewsPublic Health UpdateWorld News

World AMR Awareness Week 2023: Preventing Antimicrobial Resistance Together

by Public Health Update November 18, 2023
written by Public Health Update

World Antimicrobial Awareness Week: By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia

Antimicrobial resistance (AMR) continues to pose a significant challenge to global public health, with devastating effects on the efficacy of essential medicines and the ability to effectively treat infectious diseases. Several factors, including a high population density, limited access to healthcare services, and the misuse and exploitation of antimicrobials, make the South-East Asia region particularly prone to this threat.

AMR is directly responsible for approximately 1.27 million deaths annually worldwide, with current estimates placing the number of casualties in South Asia at 389 000. If no action is taken now, it is estimated that by 2050, ten million fatalities will occur annually on a global scale, costing the global economy a total of one hundred trillion dollars. By 2050, according to a report by the World Bank, antimicrobial resistance will be responsible for a decrease of up to 3.8% in global exports, a decrease of 7.5% per year in livestock production, and an increase of $1 trillion in healthcare-related costs.

Addressing AMR entails interdisciplinary collaboration that transcends geographical, professional, and disciplinary barriers. Therefore, our region has been taking proactive measures to combat AMR. In 2011, via the Jaipur Declaration on Antimicrobial Resistance, the health ministers of the region urged coordinated action against AMR. In 2014, the fight against AMR was elevated to Flagship Priority status. Since then, the World Health Organization (WHO) has been supporting Member States on implementation of AMR national action plans (NAPs) more effectively.

World Antimicrobial Awareness Week (WAAW) is commemorated with the aim of enhancing awareness and comprehension of AMR while promoting optimal practices among the public, multisector stakeholders, and policymakers. This year, the WAAW has been rebranded as World Antimicrobial Resistance Awareness Week by the Quadripartite organizations, which consist of the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme (UNEP), the World Health organization (WHO), and the World Organization for Animal Health (WOAH). The inclusion of the term “resistance” in the acronym “AMR” more accurately characterizes the difficulty we address.

The theme of this year’s World AMR Awareness Week (WAAW) remains “Preventing Antimicrobial Resistance Together”, as in 2022. This theme emphasizes the need for collective efforts across many sectors to promote the responsible utilization of antimicrobial agents and enhance preventive strategies aimed at combating AMR. It underscores the importance of adopting a collaborative approach based on the One Health framework. One Health is the recognition and understanding that the health of humans, animals, and the environment are interconnected and interdependent. This holistic approach considers the health of all living beings and the ecosystems they inhabit as interconnected and mutually influencing. It is imperative to foster collaboration among many sectors and stakeholders involved in the domains of human, terrestrial, and aquatic animal and plant health, as well as food and feed production and environmental conservation. This collaboration should encompass effective communication, strategic planning, and concerted efforts towards shared objectives.

In order to maintain and expedite progress, it is imperative to strengthen multisectoral coordination, which facilitates the development and implementation of policies and regulations related to AMR. Collaboration among different sectors allows for the alignment of policies, regulations, and guidelines, ensuring consistency and coherence in approaches across sectors. It enables the harmonization of surveillance systems, antimicrobial stewardship programmes, infection prevention and control measures, and the regulation of antimicrobial use in human and animal health.

Preventing Antimicrobial Resistance is not a responsibility that can be borne by any one individual, organization, or country. It is a collective effort that requires our unwavering commitment. Let us use this week to reflect on the importance of collaboration, learn from one another, and renew our determination to tackle this multi-faceted challenge head-on.

We are at a critical juncture in our fight against AMR, and the choices we make today will profoundly affect the health and well-being of generations to come. Let us embrace this World Antimicrobial Resistance Week with a renewed spirit of cooperation and a firm resolve to preserve these critical medicines for the betterment of humanity and the planet.

Together, we can make a difference, and together, we can prevent antimicrobial resistance.

November 18, 2023 0 comments
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World Diabetes Day
Non- Communicable Diseases (NCDs)PH Important DayPublic HealthPublic Health Update

World Diabetes Day 2023: Access to Diabetes Care

by Public Health Update November 13, 2023
written by Public Health Update

World Diabetes Day 2023: Access to Diabetes Care– By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia

Access to quality healthcare is a fundamental human right, yet millions of people around the world still face significant barriers in accessing diabetes care. The theme for World Diabetes Day 2023, “Access to Diabetes Care” aligns with the World Health Organization (WHO) South-East Asia Region’s NCD flagship.

Globally, around 422 million people have diabetes, and 1.5 million deaths are directly attributed to diabetes every year. In the WHO South-East Asia Region, more than 96 million people are estimated to have diabetes. Diabetes and its complications (blindness, kidney failure, heart attack, stroke, and lower limb amputation) bring about substantial economic loss to people with diabetes and their families, and to health systems and national economies. This toll is manifested through direct medical expenses and the loss of work and wages. The predictions regarding the future economic burden of diabetes are as alarming as those regarding its future prevalence.
WHO South -East Asia Region has taken several measures to address this growing health challenge in alignment with the strategies of the WHO Global Diabetes Compact. The Seventy-sixth session of the WHO Regional Committee for South-East Asia endorsed the SEAHEARTS (WHO HEARTS package adaptation to SE Asia Region), to accelerate CVD risk reduction and to place 100 million people with diabetes and hypertension on protocol-based management by 2025. These interventions will enhance access to diabetes care and reinforce NCD services at the primary health care level.

Countries in the region have made commendable progress in reducing tobacco use and have taken various measures to promote physical activity, healthy diet, and the adoption of healthy lifestyle, which are essential for reducing the risk of diabetes. Access to diabetes care services continues to expand in the Region. India has placed more than 24 million people with hypertension and diabetes on standard care. Thailand has 3.4 million patients registered for diabetes treatment and having a control rate of 33 %. The WHO NCD Country Capacity Survey of 2021 has indicated that in most countries in the region, the essential medicines and technologies for diabetes management are ‘generally available’ in primary healthcare centers. Healthcare providers are being trained to prevent and manage diabetes using WHO’s technical package for diabetes, HEARTS-D, tailored to the national context. Emerging technologies, including Artificial Intelligence -based solutions, are being explored for the early detection of diabetes complications among enrolled patients.

Improving access to care for diabetes is a priority for the Region. WHO appeals to countries and stakeholders to take measures through several key avenues that includes:

First, it is imperative to scale up the efforts to reduce risk factors adopting a life course approach. This will need a ‘whole- of-society’ and ‘whole- of-government’ approach along with social participation.

Second, a focus on bridging the treatment gap and achieving better disease control among patients is essential. This can be achieved through application of treatment protocols delivered through trained caregivers, and equipping primary healthcare with advanced technology, including HbA1c testing for disease monitoring. Additionally, efforts should be enhanced to make diabetic drugs, including insulin, more affordable and accessible in primary health care.

Third, timely diagnosis and management of complications of diabetes, with a specific focus on high-risk individuals has to be taken up as part of the care continuum. Implementing up-to-date guidelines for early complication detection, establishing efficient referral pathways for patients to access higher-center evaluations, and enabling teleconsultation to enhance healthcare accessibility are critical components.

Fourth, implementing an information system that facilitates longitudinal monitoring and follow-up of individuals, and utilizing digital solutions to measure a minimal set of indicators, is critical. Furthermore, investment in research and technology to simplify self-care management is needed.

Diabetes care should be within reach, economical, and of high quality for all, irrespective of their socio-economic status or geographical location. It is a shared responsibility of everyone including governments, healthcare providers, and communities. Small investment today can lead to big gains in the future. This World Diabetes Day under the theme of Access to Diabetes Care, together, let’s strive to promote the key message “Know your risk, Know your response.”


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November 13, 2023 0 comments
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