List of Candidates for WHO SEARO Regional Director
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Health Ministers meet next week on priority issues, to nominate next WHO Regional Director for South-East Asia

by Public Health Update
written by Public Health Update

New Delhi | October 28, 2023: Health Ministers and senior officials from Member countries are meeting here next week to deliberate on priority health issues and nominate the next World Health Organization Regional Director for South-East Asia. 

The Seventy-sixth Session of the WHO Regional Committee for South-East Asia, the annual governing body meeting of WHO at the regional level, will be held from 30 October – 2 November 2023.

WHO Director-General Dr Tedros Adhanom Ghebreyesus and WHO South-East Asia Regional Director Dr Poonam Khetrapal Singh will be present.

Accelerating prevention and control of cardiovascular diseases, ending neglected tropical diseases, and regional health security, are among the key issues to be discussed.

A ministerial roundtable will be held on strengthening primary health care as a key element towards achieving universal health coverage.

On Wednesday the Regional Committee will vote to nominate the next WHO Regional Director for South-East Asia. There are two candidates in the fray – Bangladesh nominee Ms Saima Wazed and Nepal nominee Dr Shambhu Prasad Acharya. The nomination will be submitted to the WHO Executive Board which takes place from 22 – 27 January 2024 in Geneva, Switzerland. The newly appointed Regional Director will assume office on 1 February 2024 for a five-year term.

At the Regional Committee, countries will be felicitated for public health achievements, many of them triggered by the focused approach towards the regional flagship priorities.

Home to more than 2 billion people, the Region has made accelerated progress around the Regional Flagship programmes. Since 2014, the Region has eliminated polio and maternal and neonatal tetanus. Four countries – Bhutan, Maldives, Sri Lanka and Timor-Leste have eliminated measles and rubella, one of the eight flagship priorities.

Prioritizing elimination of neglected tropical diseases, four countries – Maldives, Sri Lanka, Thailand, and Bangladesh have eliminated lymphatic filariasis. Nepal and Myanmar eliminated trachoma, and India was verified yaws-free.

Sri Lanka and Maldives eliminated malaria. Thailand, Maldives and Sri Lanka eliminated mother-to-child transmission of syphilis and HIV. Bangladesh, Bhutan, Nepal and Thailand achieved hepatitis B control.

Focusing on accelerating reduction of maternal, neonatal and under-5 mortality, the Region recorded 68.5 % reduction in maternal mortality between 2000 and 2020, and 45% reduction in under-5 mortality and 39% reduction in neonatal mortality during the period. Five countries – DPR Korea, Indonesia, Maldives, Sri Lanka and Thailand have achieved 2030 SDG targets of reducing under 5 mortality and neonatal mortality.

The Region witnessed fastest decline in tobacco use between 2000 and 2020 with smoking among men declining from 50% to 20%; and among women declining from 8.9% to 1.6%. Countries in the Region have been leading in implementation of graphic warning on tobacco.

Prone to health emergencies, the Region had been investing in strengthening preparedness and response capacities since the 2004 Indian Ocean tsunami that hit multiple countries in the Region and killed over 200,000 people. Strengthening health emergencies capacities has also been a regional flagship since 2014. Countries have been enhancing International Health Regulation (2005) core capacities. The lessons from COVID-19 pandemic are now guiding Regional Strategy Roadmap on Health Security and Health System Resilience for Emergencies 2023-2027.

The Region is accelerating control of cardiovascular diseases with a target to place 100 million people with hypertension and/or diabetes on protocol-based management by 2025.

Committed to accelerating universal health coverage, with the focus on human resources for health and essential medicines, the availability of doctors, nurses and midwives has increased by over 30.6% since 2014. Countries in the Region have been taking several initiatives to make universal health coverage a reality.

For more information on the Seventy-sixth Session of the WHO Regional Committee for South-East Asia, please visit – https://www.who.int/southeastasia/about/governance/regional-committee/seventy-sixth-session  

To watch live streaming of the Seventy-sixth Session of the WHO Regional Committee for South-East Asia please click on – https://www.youtube.com/user/whosoutheastasia

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Health for All
Global Health NewsPrimary Health CarePublic Health NewsPublic Health UpdateUniversal Health CoverageWorld News

Back to the future: harnessing the power of primary health care to transform our health systems

by Public Health Update
written by Public Health Update

Astana, Kazakhstan, 24 October 2023

In marking the 45th anniversary of the historic Declaration of Alma-Ata, the WHO Regional Office for Europe calls on Member States to reframe and invest in PHC as the backbone of #HealthForAll

Astana Declaration on Primary Health Care 2018

As the permacrisis of this day and age takes an ever-greater toll on health systems globally, urgently rethinking and prioritizing primary health care (PHC) as an essential pillar of universal health coverage is not an option, but a must. This requires governments and health authorities to refocus and restrategize on what PHC should be; innovate to harness current and future technological advances; and, ultimately, return to and strengthen the human connection between health providers and those they serve. This will bring about better health outcomes, foster individual and community well-being, strengthen earlier access to health services and help restore public confidence in the health sector.

This was the call to action issued by the WHO Regional Office for Europe, the Ministry of Healthcare of Kazakhstan and the United Nations Children’s Fund (UNICEF) Europe and Central Asia Regional Office, organizers of this week’s International Conference on Primary Health Care in Astana, commemorating both the 45th anniversary of the Declaration of Alma-Ata and the 5th anniversary of the Declaration of Astana. 

Back to the future

The COVID-19 pandemic accelerated the impetus to innovate and transform health services delivery, demonstrating that change is both necessary and possible. 

“We’re essentially advising countries to go ‘back to the future’ – to reclaim the promise of achieving health for all through PHC, embedded in Alma-Ata 1978 and Astana 2018, and convert that promise into a reality that uses innovation, such as new technology that simply wasn’t available 45 years or even 5 years ago,” said Dr Hans Henri P Kluge, WHO Regional Director for Europe. 

“And as we work hard to leverage this digital transformation and make sure everyone benefits from it equally, let us not forget the human element. Compassionate care – for both physical and mental health – is what will allow us to truly leverage the benefits of digital tools and other technology, because compassion and solidarity are at the heart of what primary health care really is. In other words, we must strive to be digital but human.”

Kazakhstan’s inspiring example

At this week’s conference in Astana, representatives from many of the 70 WHO Member States attending from across the world shared their PHC experiences – challenges and successes alike. Among them was the host Kazakhstan, whose Minister of Healthcare, Dr Azhar Giniyat, spelled out her country’s triumph in primary health care, using the integration of mental health services as an example. 

“We’ve moved away from a purely biomedical approach and incorporated mental health services and social support in our multidisciplinary primary health care teams, putting patients’ needs at the centre, listening to them, and adjusting the way in which services are delivered to meet the needs of the community,” explained Minister Giniyat. “Shifting mind-sets created the foundation for change. We’ve significantly increased funding to primary health and changed the university curricula at all levels of medical education to include these new approaches.”

High-level political commitment, including from President Kassym-Jomart Tokayev, has improved funding mechanisms and advanced the digitalization of PHC. There is clear evidence that prioritizing PHC yields dividends. For example, the suicide rate among adolescents in Kazakhstan has fallen by more than two-and-a-half times, and premature mortality from noncommunicable diseases continues to decline.

The way forward

“Primary health care begins and ends with people, and Kazakhstan is showing the way forward,” said Dr Natasha Azzopardi-Muscat, Director, Country Health Policies and Systems, WHO Regional Office for Europe. “First and foremost, by demonstrating how political will can help prioritize PHC services, including in the most hard-to-reach communities. Second, by meeting the needs of the primary care workforce, to ensure they are supported and enabled to provide essential services with a truly human touch. Then, by embracing innovation, including through the use of digital tools, so that primary health care can more easily deliver health to the people when and where they need it.” 

“The WHO Regional Office for Europe is calling for a comprehensive change in the way we think about, and carry out, primary health care, starting with the need for PHC to be complemented and supported by fit-for-purpose hospitals that meet people’s changing health needs,” concluded Dr Kluge. 

“And as we look at what needs to be done next, countries should increase public health spending in PHC and improve the working conditions of the PHC workforce, so that a career in PHC becomes the career of choice for the next generation of health workers. 

“When we endorsed Alma-Ata 1978, the then WHO Director-General Halfdan Mahler said, ‘The greatest potential energy in the world is human energy, and health is the fuel that can generate it’. Let’s reach back in time even as we look forward, connecting the past with the future of health, through the practical, actionable promise of primary health care for all.”

WHO

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Postdoctoral Opportunity in Public Health/Global Health
PostDocPublic Health OpportunitiesPublic Health Opportunity

Postdoctoral Opportunity in Public Health/Global Health

by Public Health Update
written by Public Health Update

The Norwegian Institute of Public Health’s vision is better health for all. We produce, summarize and communicate knowledge for the public health sector and healthcare services. Our main activities are emergency preparedness, knowledge and infrastructure. Infrastructure comprises registries, health surveys, biobanks and laboratory services. The Institute is a government organization under the Ministry of Health. We have approximately 1200 employees located in Oslo and Bergen.

The Institute is committed to diversity. We urge qualified candidates to apply for a job with us, regardless gender, age, disability, ethnic or national background, or if there are periods of absence from work. 

Postdoctoral Position in Public Health/Global Health, Helsetjenester, Folkehelseinstituttet FHI

Application deadline: 10.11.2023
Employer: Folkehelseinstituttet FHI
Town/city: Oslo
Title: Post Doc ved Klynge for global helse
Positions: 1
Full-time/part-time: Full-time
Employment type: Temp
Percentage of full-time: 100
Webcruiter ID: 4717482454

The Norwegian Institute of Public Health (Folkehelseinstituttet, FHI) has a postdoctoral position available for a fixed term of three years. The postdoctoral researcher will work on the project titled “Implementing a life course approach in antenatal and postnatal care settings for prevention and reduction of non-communicable disease risks in Nepal (IpreventNCD)”. This project is funded by the Research Council of Norway and Australia’s National Health and Medical Research Council through an international joint call on a life course approach to the prevention and reduction of common non-communicable disease (NCD) risk factors, organized by the Global Alliance for Chronic Diseases. The IpreventNCD project is led by NIPH and the University of Queensland, and will be carried out in partnership with the University of Bergen, Nepal Health Research Council, Kathmandu University School of Medical Science, and Central Queensland University.

In IpreventNCD, our goal is to work with users and stakeholders to understand the barriers and enablers for implementing NCD risk reduction interventions in antenatal and postnatal care settings in Nepal. We will use these barriers and enablers to develop implementation strategies. Finally, we will assess whether the NCD interventions and implementation strategies are acceptable, feasible, and effective in reducing NCD risks among young women during and after pregnancy.
The postdoctoral researcher will play a central role in mapping the barriers and enablers, as well as in developing implementation strategies in collaboration with users and stakeholders. Two PhD candidates, affiliated with the University of Bergen, but based in Nepal, will also be hired. As a postdoctoral researcher on the project, you will collaborate closely with the researcher team, which includes members from various research institutions, and stakeholders in Nepal. You will have access to the resources and networks of the Global Alliance for Chronic Diseases.

The position will be affiliated with the Global Health Cluster in the Division of Health Services at FHI in Oslo. At FHI, you will be part of the Nepal and Global NCD teams, and the implementation research network. 

Key Responsibilities 

  • Acquire a solid understanding of the literature on the implementation of NCD interventions.
  • Examine the barriers and enablers for implementing NCD preventive interventions in antenatal and postnatal care settings in Nepal.
  • Identify implementation strategies tailored to the local context and the identified barriers and enablers.
  • Develop protocols for the assessment of NCD interventions and implementation strategies.
  • Conduct statistical analysis and/or qualitative analysis.
  • Write scientific articles for publication in international journals.
  • Disseminate results in various scientific and popular science forums and contribute to the organization of meetings and seminars.
  • Contribute to the further development of the project, both scientifically and through applications for external funding.
  • Supervise students, including PhD candidates.
  • Maintain and establish national and international collaborations with relevant colleagues and research environments. 

Qualifications 

  • A PhD in medicine, health sciences, public health, global health, social sciences, or a related field.
  • Strong skills in data collection and analysis, and the interpretation of qualitative and/or quantitative data.
  • Experience working in and with partners from low- and middle-income countries, preferably in Nepal.
  • Experience in implementation research is a plus.
  • Willingness and ability to travel internationally for short periods of time.
  • Excellent written and oral communication skills in English.
  • Proficiency in written and spoken Norwegian is desirable but not mandatory. 

Personal Qualities 

  • Ambitious and motivated for research.
  • Reliable and responsible, with a strong work ethic and capacity.
  • Solution-oriented, creative, and proactive.
  • Structured and meticulous.
  • Goal-oriented, skilled in prioritization and self-management.
  • Strong collaboration and communication skills, with the ability to develop relationships and networks effectively. 

Offer 

  • A three-year postdoctoral position with a competitive salary in accordance with the government’s pay scale.
  • An interesting job with the opportunity to produce high-quality research results.
  • Access to a large international network of highly qualified researchers.
  • Flexible working hours and good welfare benefits, including on-site exercise opportunities.
  • Good pension benefits through the Norwegian Public Service Pension Fund.
  • Type of Appointment: Temporary Start Date: January 1, 2024, or as agreed.

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Dr Saia Ma’u Piukala nominated to lead WHO Western Pacific Region
Global Health NewsNational Health NewsPublic HealthPublic Health NewsPublic Health UpdateWorld News

Dr Saia Ma’u Piukala nominated to lead WHO Western Pacific Region

by Public Health Update
written by Public Health Update

Dr Saia Ma’u Piukala has been nominated as the next World Health Organization (WHO) Regional Director for the Western Pacific. Health ministers and other senior officials from the Region’s Member States voted today during the seventy-fourth session of the WHO Regional Committee for the Western Pacific.

Proposed by Tonga, Dr Piukala is a surgeon with nearly 30 years of experience as a public health leader working in Tonga and across the Pacific. He is a champion of multisectoral collaboration to address health challenges, such as climate change, noncommunicable diseases and tobacco control, among others. Since becoming Tonga’s Minister of Health, he has been very involved in the work of WHO, advocating and championing initiatives on noncommunicable diseases, safe surgery, climate change and health, and disaster preparedness and response.

Addressing the Regional Committee and the WHO workforce, Dr Piukala said, “At home, we say that it takes a village to raise a child. Today, I stand here before you, not as Saia Ma’u Piukala, but as someone who is here because of that village. That village was not just in Tonga. It was my experience in the many places I have been, including Pacific Island Countries, all of the WHO work and meetings, across the Western Pacific Region and at the World Health Assembly in Geneva. My fellow villagers – including all of you – I am very grateful. The outcome today is not of my doing, but a result of the contribution of my fellow villagers, including all of you and many others who are not here today. I thank you sincerely for the trust you have placed in me today. I know that to whom much is given, much is expected, and I look forward to working with you to make our Region the one we want it to be.”

WHO Director-General, Dr Tedros Adhanom Ghebreyesus, who is attending the Regional Committee in Manila this week, congratulated Dr Piukala on his nomination as the next Regional Director for the Western Pacific: “This Region is home to almost one quarter of the world’s population, and it is among the most diverse of WHO’s six regions – from the steppes of Mongolia to the beaches of the Pacific, from the world’s largest and most crowded cities to some of its most remote villages – the Western Pacific is a Region of incredible contrasts, unique challenges and unlimited potential. The diversity of landscapes, languages, cultures and traditions is immense, and so is the scale of health challenges. Dr Piukala, you have not applied for an easy job. But you have applied for one of the most important, and one of the most rewarding. It will demand all of the technical, managerial, and diplomatic skill and experience you have. But you are not alone. You are supported by a very dedicated and talented team. And I assure you of my support and that of my colleagues in Geneva. You have my full support, my full confidence and my best wishes. I look forward to working with you as we chart a path forward together.”

The Acting Regional Director for the Western Pacific, Dr Zsuzsanna Jakab served the Region since August 2022, initially as Officer-in-Charge and then as Acting Regional Director since March 2023. She also offered her successor warm wishes: “I congratulate Dr Piukala for being nominated as the next WHO Regional Director for the Western Pacific,” she said. “From February 2024 onwards, I am confident that you will continue to lead the important work of WHO in this Region, hand-in-hand with our diverse workforce, Member States and partners. I look forward to handing over a well-functioning office that is ready for the challenges of the coming years.”

Additional information on the RD elect, Dr Piukala, including his bio, photo, etc. can be found here.

17 October 2023 (WHO)

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WHO announces the elimination of lymphatic filariasis as a public health problem in the Lao People’s Democratic Republic
Global Health NewsNeglected Tropical Diseases (NTDs)Public HealthPublic Health NewsPublic Health UpdateWorld News

The Lao People’s Democratic Republic eliminates lymphatic filariasis

by Public Health Update
written by Public Health Update

The World Health Organization (WHO) announced that the Lao People’s Democratic Republic has eliminated lymphatic filariasis, a painful and disabling neglected tropical disease, as a public health problem. This landmark achievement exemplifies the nation’s commitment to health, and the culmination of decades-long dedicated efforts by the Lao government, health-care workers, communities, and national and international partners. This is the second neglected tropical disease (NTD) that the country has eliminated following the elimination of trachoma as a public health problem in 2017.

“I would like to congratulate the Lao People’s Democratic Republic for being verified for the elimination of the neglected tropical disease of lymphatic filariasis as a public health problem,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The result is a testament to Lao PDR’s dedication to and investment in protecting and promoting its people’s health.” He presented a plaque and certificate to Lao Minister of Health His Excellency Dr Bounfeng Phoummalaysith in recognition of the achievement during the seventy-fourth session of the Regional Committee for the Western Pacific this week in Manila, Philippines

“Our country’s achievement has been made possible through years of collective efforts by dedicated health workers together with support from WHO and partners, including the United States Agency for International Development (USAID), the Asian Development Bank, the Margaret A. Cargill Foundation, Family Health International (FHI 360) and RTI International,” says Dr Bounfeng Phoummalaysith. “Lymphatic filariasis will never regain a foothold in our country. We will continue to maintain our efforts to prevent and control the disease through surveillance and respond quickly to any cases.”

Lao PDR joins 12 other countries and areas in the Western Pacific Region that have achieved this milestone since 2000, including Cambodia, China, Cook Islands, Kiribati, Niue, the Marshall Islands, Palau, the Republic of Korea, Tonga, Vanuatu, Viet Nam, and Wallis and Futuna.

Dr Zsuzsanna Jakab, Acting WHO Regional Director for the Western Pacific says: “The success story of eliminating lymphatic filariasis in Lao PDR is a testament to the power of collective actions between the Government, partners, communities and health-care workers to deliver public health results. This achievement reminds us that we can overcome even the most daunting health challenges with determination, commitment and collaboration.”

A major national event will be held in the Lao province of Attapeu on 27 October to mark the accomplishment. 

Lymphatic filariasis, commonly known as elephantiasis, is a parasitic disease spread by mosquitoes that causes the enlargement of body parts, often resulting in pain, severe disability, stigma and associated economic hardship.

To eliminate the disease, which by 2002 was endemic in only one southern Lao province (Attapeu), local health authorities and partners gave preventive medication to at-risk communities from 2012 to 2017. Elimination efforts also benefited from activities to reduce malaria and dengue, including distribution of long-lasting insecticide-treated nets and health education campaigns. Partners and donors have supported activities including medication administration, monitoring visits and a survey to assess the disease’s transmission.

16 October 2023 (WHO)

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National Health Financing Strategy 2080- 2090
Health SystemsNational Plan, Policy & GuidelinesPublic Health UpdateResearch & Publication

National Health Financing Strategy 2080- 2090

by Public Health Update
written by Public Health Update

The Government of Nepal has recently endorsed a new ten-year strategy for health financing with the aim of ensuring equitable financial management to achieve universal health coverage (UHC) in Nepal. The National Health Financing Strategy 2080- 2090 includes strategic interventions to expand fiscal space for health, strengthen social protection, improve resource generation, and improve health financing governance, accountability, and transparency in the health sector.

The National Health Financing Strategy aims to achieve the provision of ensuring health as a fundamental right as per the mandate of the Constitution of Nepal 2015.

DOWNLOAD PDF FILE

DOWNLOAD PDF FILE

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Dr Hanan Balkhy has today been nominated as the next WHO Regional Director for the Eastern Mediterranean
Global Health NewsPublic Health NewsPublic Health UpdateWorld News

Dr Hanan Balkhy has today been nominated as the next WHO Regional Director for the Eastern Mediterranean

by Public Health Update
written by Public Health Update

Dr Hanan Balkhy has been nominated as the next WHO Regional Director for the Eastern Mediterranean.

Member States voted to nominate Dr Balkhy during a closed meeting at the 70th session of the WHO Regional Committee for the Eastern Mediterranean. The nomination will be submitted to the WHO Executive Board during its 154th session, taking place on 22−27 January 2024 in Geneva, Switzerland. The newly appointed Regional Director will take office on 1 February 2024.

List of Candidates for WHO SEARO Regional Director

Dr Balkhy will direct international health work across the 22 countries and territories of the Eastern Mediterranean Region, serving a population of 745 million people. She had a distinguished career in medicine, as well as in medical and health-related research, with a special focus on public health challenges. She also has a strong background in the technical and public health sectors at the national, regional and international levels. Prior to her nomination as Regional Director, Dr Balkhy had been the Assistant Director-General for Antimicrobial Resistance at the WHO headquarters in Geneva, Switzerland since 2019.

Born in Saudi Arabia, Dr Balkhy was the first Executive Director for Infection Prevention and Control at the Saudi Arabian Ministry of National Guard. Seen as a leading expert at the regional and international levels, Dr Balkhy has provided important guidance to the WHO Regional Office for the Eastern Mediterranean and WHO headquarters, which has had a significant impact.

For more than 10 years, she successfully led both the Gulf Cooperation Council Centre for Infection Control and the WHO Collaborating Centre on Infection Prevention and Control and Antimicrobial Resistance. This experience culminated in her appointment as WHO’s first Assistant Director-General for Antimicrobial Resistance.

Dr Balkhy is the seventh Regional Director nominated to lead the Regional Office for the Eastern Mediterranean, and the first female to receive such nomination. Following appointment by the Executive Board at its 154th session in January 2024, she will take over from the current Regional Director, Dr Ahmed Al-Mandhari, whose 5-year term ends on 31 January 2024.

World Health Organization (Eastern Mediterranean Regional Office)

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The 8th Global Symposium on Health Systems Research (HSR 2024)
ConferenceInternational Jobs & OpportunitiesPublic Health EventsPublic Health OpportunitiesPublic Health Opportunity

The 8th Global Symposium on Health Systems Research (HSR 2024)

by Public Health Update
written by Public Health Update

The 8th Global Symposium on Health Systems Research (HSR 2024) will be held in Nagasaki, Japan. The selected bid was presented by Nagasaki University in consortium with the Japan International Cooperation Agency (JICA).

2024 Theme: Building Just & Sustainable Health Systems: Centering People and Protecting the Planet.

SUB-THEME 1: Strengthening Health Systems for Planetary Health

The linkages between planetary health and health system functions remain neglected in research and policy dialogue on health policy and systems community. The sub-theme strengthening health systems for planetary health emphasizes the need for a concerted effort to build health system research, policy, and programmatic momentum in the following areas.

Strengthening climate-resilient health systems: The health of populations – humans and other species – is deeply intertwined with the health of our planet. Yet our health systems, which have traditionally focused on treating illness, are often inflexible by design, and must adapt to address the complex challenges posed by climate change, urbanization, biodiversity loss, and pandemics. We welcome submissions on research exploring the infrastructural and workforce adaptations required to ensure climate-resilient health systems; how climate change may undermine health service delivery, and how systems respond to shifts in service demand associated with disease or population movement. We welcome learnings from experiences of bringing health system experts together with community representatives, activists and Indigenous populations, and non-health disciplines such as social science, climate services, ecology, engineering, futurology, to address climate resilience. Submissions that explore the role of community-based strategies, participatory approaches, and highlight the role of local and Indigenous knowledges in informing efforts to improve climate-resilience health systems, are particularly welcome.

Strengthening environmentally sustainable health systems: Health systems contribute significantly to environmental change and degradation through resource consumption, waste generation, and energy usage. We welcome submissions focused on the science and practice of building sustainable, climate-resilient health systems. This includes forward-thinking work that reimagines healthcare delivery models that are both resilient and low-carbon; One Health approaches capable of responding to complex challenges posed by climate change, rapid urbanization, biodiversity loss, and new pandemics; and private sector engagement looking at environmentally sustainable health care and climate-related commercial determinants of health.

Policy creation and governance for climate resilient and sustainable health systems: Health systems and policy research that engages with policy creation and governance for climate-resilient and sustainable health systems is lacking. This includes macro-level explorations of the political economy of health system adaptation and transformation – e.g. how to navigate the lack of financing within low- and middle-income countries, to effectively support health systems climate change adaptation; down to meso- and micro-level research on the impacts of policy inconsistency and gaps at sub-national (provincial, district, and primary care) levels on public health adaptation to climate change. Health system leaders also have an important role in the prevention and mitigation of current and further planetary damage. We encourage submissions examining the role of health systems leaders as advocates for policies and interventions that address the root causes of planetary health challenges, promoting sustainable practices and fostering a healthier planet for present and future generations.

SUB THEME 2: Advancing justice, inclusion, and belonging in health systems, in times of peace and conflict

Everyone has the right to access quality health care, regardless of their race, ethnicity, gender, disability, socioeconomic status and related conditions. The sub-theme: “Advancing justice, inclusion, and belonging in health systems, in times of peace and conflict,” reflects the ongoing need to identify gaps, and strengthen action on inclusivity and belonging to ensure health systems mediate and redress social inequity rather than deepen it. We welcome submissions in the following areas.

Centering lived experiences in health system: Around the world, and particularly in settings of conflict, people are denied access to health care due to discrimination, health system disruption, service siloes, and scarce resources. We welcome submissions that center lived experiences of the different needs, protections, and expectations of health systems by vulnerable populations (including Indigenous peoples, women, refugees, internally displaced persons, ethnic minorities, LGBTQIA+, people living with disability, people of colour and aging populations) in alternative policy and service-delivery frameworks. Research reflecting on and synthesizing the relational, access-related and quality dimensions of those experiences to consider what it takes to transform health systems is encouraged. HSR2024 seeks to advance discussions about the role of intersectionality and power in health policy and system practice.

Implementation research and practical efforts to advance justice, inclusion and sustainability: Knowledge silos create barriers to transformation health system strengthening. We encourage submissions that describe and evaluate reforms and initiatives advancing justice, inclusion, and belonging across all health system domains. Research focusing on the mechanisms (e.g. financing, legislative, regulatory, activist, community engagement, service re-design) and contextual factors required to both catalyse and sustain meaningful improvements in service coverage and quality is welcome. Work that identifies the adaptive capacities and mechanisms that advance justice, inclusion and belonging in fragile and conflict-affected health systems is particularly needed. Recognising the equity-promoting potential of different health financing models, research focused on new approaches to health financing, and mixed service models that address health system discriminiation and improve health outcomes is welcome. We also encourage research and programmatic learnings from initiatives that address management and organizational bias through purposeful leadership and reflexive workforce practice.

Transforming structural change: Systemic, structural, institutional and interpersonal racism and discrimination have hugely detrimental effects on health outcomes. Work that explores and showcases structural reforms necessary to tackle racism, discrimination, disrespect and abuse, in health systems is encouraged. We welcome submissions that explore the design and implementation of transformative approaches to public health and health service delivery specifically aimed at dismantling such systemic and historical barriers. We welcome practical examples and critical evaluations of initiatives seeking to counter epistemic injustice by centering or integrating Indigenous knowledge systems to realise the rights of marginalized peoples. Sharing research, policies, and interventions that explore strengths-based methodologies and strategies for cultivating respectful people-centered health systems is welcomed.

SUB THEME 3: Health governance, policy and institutional frameworks for just and sustainable health systems.

Effective health governance, policy and institutional frameworks that embody it, should help to create a shared understanding, facilitate coordination and collaboration and encourage accountability, multiple gaps exist in our understanding of how to define, design and enact such institutions in the face of rapidly evolving technological, politico-economic and epidemiologic imperatives. The sub-theme Health governance, policy, and institutional frameworks for just and sustainable health systems emphasizes the need for analytical and empirical work focused on the following areas.

Governance and institutional frameworks for complex health systems: Although good health governance is foundational to the goal of promoting justice and sustainability, the policies and institutional frameworks that give expression to it within complex health systems, are not a given. We welcome submissions that explore the complexities of, and strategies for, developing policy and institutions that strengthen cross-sectoral (public-private, and health-non-health) cooperation, and that explore the role of markets in achieving, distorting, or innovating a path towards high-quality health systems. Of particular interest is work exploring the levers of influence and modes of engagement that are, or could, be used by governments within mixed health systems, and research to understand the varied interests of private sector actors (small and large) and whether and how they align with the goals of a just and sustainable health system. Relatedly, we encourage submissions that map the institutional eco-system within mixed health systems, identify gaps, and propose reforms at system or organizational levels.

Within this sub-theme, we also encourage cutting-edge research and case studies that deepen our understanding of the structural causes of a near-perpetual crisis in human resources for health, including the nature and impact of public policy settings to support or discourage health worker migration, and the implications of migration for geopolitics, peace-building and global health diplomacy; the political economy of health workforce reform in the context of dynamic industrial, political and social conditions; and innovative approaches to health workforce management for dispersed populations including in remote area locations and small-island, and archipelagic nations.

Governance to strengthen public health & address commercial and cultural determinants:  In this “post” pandemic era, we welcome submissions that deepen our understanding of how to strengthen governance for just and sustainable public health functions and population health. Priority topics include: the sufficiency of national policy settings and institutional frameworks for ensuring a skilled public health workforce in both pandemic and non-pandemic times; policy frameworks for integrated health information systems that inform real-time decision-making and more effective use of resources; state-of-the-art policies and strategies (‘offensive’ and ‘defensive’) including modes of surveillance for addressing commercial determinants of health; and approaches to governance that enhance community responsiveness and rebuild trust. Since health governance and institutional frameworks are constituted and function at the global, as well as national and sub-national and local levels, we strongly encourage submissions that deepen our understanding of the impacts of power dynamics and political economy of health policy and governance outcomes in different settings.

Stewardship of digital transformations including AI and big data: The role of technology in health systems globally, and the accelerating rate of digital transformation, cannot be overstated. The WHO Global Strategy on Digital Health 2020-2025 recommends that digital technologies be viewed as “an essential component and an enabler of sustainable health systems and universal health coverage”. Yet many concerns remain regarding the adequacy of stewardship and institutional frameworks governing transformative technologies, including private and security concerns and ethical considerations in the use of AI and machine learning. We welcome submissions focusing on empirical and normative aspects of the governance of digital technologies in health systems, and the formulation of regional, national or sub-national digital health strategies to support health system and population health improvement. In the context of these actual or aspirational transformations, we also encourage submissions exploring the institutional frameworks and regulatory infrastructure necessary to engage with and manage the interests of a rapidly changing information technology sector; and the sufficiency of existing mechanisms of participatory governance for ensuring social accountability and trust, in the context of such change.

SUB THEME 4: Knowledge for just health systems

The production and use of knowledge for health policy and systems is influenced by epistemological, ethical and methodological choices, in turn reflecting the underlying values of both researchers and practitioners. The sub-theme: Knowledge for just health systems aims to extend and amplify conversations about these choices and stimulate debate and shared learning around approaches to the production and use of knowledge better aligned with a just and sustainable health system.

Challenging & transforming epistemic injustice in research, learning & teaching: The production, co-production of knowledge for health policy and health systems is structured by problematic hierarchies of knowledge, evidence and language, and reflected in the exclusion and marginalization experienced by many groups. We welcome submissions that identify, challenge and seek to transform these injustices in research, and learning and teaching practice. We encourage work that explores the significance of intersectionality and the role of social identities in shaping the creation of knowledge; and which explores the transformative potential of Indigenous and other knowledge systems. We welcome explorations of ethical frameworks, anti-racist and power-sensitive methodologies, and knowledge dissemination and publishing practices that invert established power relations, including the centering of data sovereignty and cultural governance. In relation to learning and teaching, we welcome work examining curriculum design and modes of delivery that promote pluriversality and submissions that reflect on the role of counter-narratives and other anti-colonial approaches. More broadly, we seek experiences of field building and reflections on the HPSR competencies required to support and strengthen reflexive, ‘learning health systems’; and health policy and systems teaching and learning strategies, including pre-professional, continuing professional education that actively reflect on knowledge production and use for just health systems.

Surfacing values: Values provide a normative foundation upon which health policy and systems are designed, implicitly guiding decision-making processes in ways that reinforce established approaches to knowledge production, sharing, and utilization. We encourage submissions that explore and identify the values and social identities guiding health system research, learning and teach practices as well as policy choices, and critically analyze the ethical implications and alignment of those choices with broader health system goals of social justice and sustainability. Submissions that explore the mechanisms, and multi-faceted conditions required to shift or embed new values, including participatory priority setting; strategies to amplify non-hegemonic perspectives; and purposeful pathways for ensuring representation in leadership.

Dissemination & translation: Effective translation, communication and integration of complex scientific and socio-cultural knowledge is essential for engaging and empowering diverse stakeholders in health system strengthening efforts. Transparent and clear communication fosters trust by grounding decisions and actions in a shared understanding of issues and diverse evidence. We welcome cutting-edge research exploring innovations in knowledge translation, and importantly, the building of systemic trust. Submissions exploring the role and different models for open-access publishing, data-sharing are encouraged, alongside those that examine best practices in knowledge translation and dissemination for promoting equitable and just health systems.

Save the date: November 18-22, 2024

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Vaccines development process & Clinical trials
Public HealthPublic Health NewsPublic Health UpdateWorld News

WHO recommends R21/Matrix-M vaccine for malaria prevention in updated advice on immunization

by Public Health Update
written by Public Health Update

The World Health Organization (WHO) has recommended a new vaccine, R21/Matrix-M, for the prevention of malaria in children. The recommendation follows advice from the WHO: Strategic Advisory Group of Experts on Immunization (SAGE) and the Malaria Policy Advisory Group (MPAG) and was endorsed by the WHO Director-General following its regular biannual meeting held on 25-29 September. 

WHO also issued recommendations on the advice of SAGE for new vaccines for dengue and meningitis, along with immunization schedule and product recommendations for COVID-19.  WHO also issued key immunization programmatic recommendations on polio, IA2030 and recovering the immunization programme.

The R21 vaccine is the second malaria vaccine recommended by WHO, following the RTS,S/AS01 vaccine, which received a WHO recommendation in 2021. Both vaccines are shown to be safe and effective in preventing malaria in children and, when implemented broadly, are expected to have high public health impact. Malaria, a mosquito-borne disease, places a particularly high burden on children in the African Region, where nearly half a million children die from the disease each year.

Demand for malaria vaccines is unprecedented; however, available supply of RTS,S is limited.  The addition of R21 to the list of WHO-recommended malaria vaccines is expected to result in sufficient vaccine supply to benefit all children living in areas where malaria is a public health risk.  

“As a malaria researcher, I used to dream of the day we would have a safe and effective vaccine against malaria. Now we have two,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Demand for the RTS,S vaccine far exceeds supply, so this second vaccine is a vital additional tool to protect more children faster, and to bring us closer to our vision of a malaria-free future.”

Dr Matshidiso Moeti, WHO Regional Director for Africa, emphasized the importance of this recommendation for the continent, saying: “This second vaccine holds real potential to close the huge demand-and-supply gap. Delivered to scale and rolled out widely, the two vaccines can help bolster malaria prevention and control efforts and save hundreds of thousands of young lives in Africa from this deadly disease.”

Key features of the R21 malaria vaccine:  

The updated WHO malaria vaccine recommendation is informed by evidence from an ongoing R21 vaccine clinical trial and other studies, which showed:

  • High efficacy when given just before the high transmission season: In areas with highly seasonal malaria transmission (where malaria transmission is largely limited to 4 or 5 months per year), the R21 vaccine was shown to reduce symptomatic cases of malaria by 75% during the 12 months following a 3-dose series. A fourth dose given a year after the third maintained efficacy. This high efficacy is similar to the efficacy demonstrated when RTS,S is given seasonally.  
  • Good efficacy when given in an age-based schedule:  The vaccine showed good efficacy (66%) during the 12 months following the first 3 doses. A fourth dose a year after the third maintained efficacy.  
  • High impact: Mathematical modelling estimates indicate the public health impact of the R21 vaccine is expected to be high in a wide range of malaria transmission settings, including low transmission settings. 
  • Cost effectiveness: At prices of US$ 2 – US$ 4 per dose, the cost-effectiveness of the R21 vaccine would be comparable with other recommended malaria interventions and other childhood vaccines. 
  • Similarity of R21 and RTS,S vaccines: The two WHO-recommended vaccines, R21 and RTS,S, have not been tested in a head-to-head trial. There is no evidence to date showing one vaccine performs better than the other. The choice of product to be used in a country should be based on programmatic characteristics, vaccine supply, and vaccine affordability
  • Safety: The R21 vaccine was shown to be safe in clinical trials. As with other new vaccines, safety monitoring will continue.

Next steps for the second recommended malaria vaccine, R21/Matrix-M, include completing the ongoing WHO prequalification which would enable international procurement of the vaccine for broader rollout.

At least 28 countries in Africa plan to introduce a WHO-recommended malaria vaccine as part of their national immunization programmes. Gavi, the Vaccine Alliance has approved providing technical and financial support to roll out malaria vaccines to 18 countries. The RTS,S vaccine will be rolled out in some African countries in early 2024, and the R21 malaria vaccine is expected to become available to countries mid-2024. ;

Recommendations on dengue

  • Dengue poses a significant public health burden in endemic countries and is poised to increase further both in terms of incidence and geographic expansion, due to climate change and urbanization.
  • The live-attenuated quadrivalent dengue vaccine developed by Takeda (TAK-003) has demonstrated efficacy against all four serotypes of the virus in baseline seropositive children (4-16 years) in endemic countries and against serotypes 1 and 2 in baseline seronegative children.
  • SAGE recommended that the vaccine be considered for introduction in settings with high dengue disease burden and high transmission intensity to maximize the public health impact and minimize any potential risk in seronegative persons.  
  • SAGE recommended that the vaccine be introduced to children aged 6 to 16 years of age. Within this age range, the vaccine should be introduced about 1-2 years prior to the age-specific peak incidence of dengue-related hospitalizations. The vaccine should be administered in a 2-dose schedule with a 3-month interval between doses.
  • SAGE recommended that vaccine introduction should be accompanied by a well-designed communication strategy and community engagement. 

Recommendations on meningitis

  • SAGE recommended that all countries in the African meningitis belt introduce the novel pentavalent meningococcal conjugate vaccine targeting serogroups A, C, Y, W and X (Men5CV) into their routine immunization programmes in a single-dose schedule at 9 to 18 months of age.  
  • In high-risk countries, and countries with high-risk districts, a catch-up campaign should also be conducted at the time of the introduction of Men5CV, targeting all individuals aged 1 to 19 years.  

  Recommendations on COVID-19

  • SAGE was presented with updated data on the epidemiology of COVID-19, including death rates among priority-use groups; vaccine effectiveness data during Omicron XBB sub-lineages circulation; and pre-clinical and clinical data on novel monovalent XBB vaccines.
  • Based on the data reviewed, SAGE recommended a simplified single-dose regime for primary immunization for most COVID-19 vaccines which would improve acceptance and uptake and provide adequate protection at a time when most people have had at least one prior infection.
  • Available data suggest the monovalent Omicron XBB vaccines provide modestly enhanced protection compared to bivalent variant-containing vaccines and monovalent index virus vaccines. 
  • When monovalent XBB vaccines are not available, any available WHO emergency-use listed or prequalified vaccine, bivalent variant-containing or monovalent index virus vaccines, may be used since they continue to provide benefits against severe disease in high-risk groups.

IA2030

  • Progress against the IA2030 indicators was stalled due to the impact of the COVID-19 pandemic and was off-track for six of the seven impact goal targets; progress against the target for the introduction of new vaccines is on track driven by the introduction of new vaccines in low-income countries in 2022. 
  • While there are promising signs of recovery, it is uneven; recovery is especially slow in low-income countries and vulnerable populations living in fragile and conflict-affected settings. 
  • Low coverage of measles-containing vaccines has increased the risk of large, disruptive outbreaks. 
  • A shared action agenda for 2023-2024 that sets out a series of short-term and high-level priorities to align the efforts of countries, regions, global partners, and other stakeholders has been developed. 
  • The action agenda has six trajectories, which are catch-up and strengthening of immunization programmes, equity promotion, regaining control of measles, making the case for investment into immunization, accelerating the introduction of WHO-recommended vaccines, and advancing vaccination in adolescence.

The R21 and RTS,S vaccines act against P. falciparum, the deadliest malaria parasite and the most prevalent on the African continent. The updated WHO recommendation for malaria vaccines was informed by the results of the WHO-coordinated Malaria Vaccine Implementation Programme, through which nearly 2 million children in Ghana, Kenya and Malawi have been reached with the RTS,S/AS01 malaria vaccine since 2019. The pilot introduction of the first malaria vaccine has resulted in a substantial impact in reducing severe malaria illness, hospitalizations and child deaths. 

2 October 2023, WHO

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World Tuberculosis Day 2021: The Clock Is Ticking
Communicable DiseasesGlobal Health NewsPublic Health NewsPublic Health UpdateWorld News

World leaders commit to new targets to end TB

by Public Health Update
written by Public Health Update

World leaders at the United Nations General Assembly’s High-Level Meeting on Tuberculosis have approved a Political Declaration with ambitious new targets for the next five years to advance the global efforts towards ending the TB epidemic.

The targets include reaching 90% of people with TB prevention and care services, using a WHO-recommended rapid test as the first method of diagnosing TB; providing social benefit packages to all people with TB; licensing at least one new TB vaccine; and closing funding gaps for TB implementation and research by 2027. 

“For millennia, our ancestors have suffered and died with tuberculosis, without knowing what it was, what caused it, or how to stop it,” said Dr Tedros Adhanom Ghebreyesus. “Today, we have knowledge and tools they could only have dreamed of. The political declaration countries approved today, and the targets they have set, are a commitment to use those tools, and develop new ones, to write the final chapter in the story of TB.”

Progress made towards 2018 targets

Taking stock of progress towards targets set in 2018 for a five-year period, WHO reported that while global efforts to combat TB have saved over 75 million lives since the year 2000, they fell short of reaching the targets, mainly due to severe disruptions to TB services caused by the COVID-19 pandemic and ongoing conflicts. Only 34 million people of the intended 40 million people with TB were reached with treatment between 2018 and 2022. For TB preventive treatment, the situation was even more grim, with only 15.5 million of the 30 million people targeted to be reached with preventive treatment accessing it.

Funding for TB services in low- and middle-income countries fell from US$ 6.4 billion in 2018 to US$ 5.8 billion in in 2022, representing a 50% financing gap in implementing the required TB programmes. Annual funding for TB research ranged from US$ 0.9 billion to US$ 1.0 billion between 2018 and 2022, which is just half of the target set in 2018.

This has placed an even heavier burden on those affected, especially the most vulnerable. Today, TB remains one of the world’s top infectious killers: annually more than 10 million people fall sick, and over 1 million lose their lives to this preventable and curable disease. Drug-resistant TB continues to be a major contributor to antimicrobial resistance with close to half a million people developing drug-resistant TB every year.

“Uniting around the TB response by world leaders, for a second time, provides an opportunity to accelerate action and strengthen health systems capable of not only addressing the TB epidemic, but also protecting the broader health and well‑being of communities, strengthening pandemic preparedness and building on lessons learnt during the COVID-19 pandemic,” said Dr Tereza Kasaeva, Director of the WHO Global TB Programme. “Averting TB-related financial hardship and preventing the development of the disease in vulnerable groups will help diminish inequities within and between countries, contributing to the achievement of the Sustainable Development Goals.”

TB incidence and deaths have risen between 2020 and 2021 but coordinated efforts by countries, WHO and partners are resulting in a recovery of essential services.

Launch of the TB vaccine accelerator council

In the lead-up to this historic meeting, WHO Director-General, Dr Tedros Adhanom Ghebreyesus, officially launched the TB vaccine accelerator council to facilitate the development, licensing and use of new TB vaccines. The Council, supported by the WHO secretariat, will be led by a ministerial board, consisting of nine members who will serve on a rotating basis, for a term of two years. The Council will also have subsidiary bodies to support its interaction and engagement with different sectors and stakeholders broadly, including the private sector, scientists, philanthropy, and civil society.

BCG is currently the only licensed TB vaccine. While it provides moderate efficacy in preventing severe forms of TB in infants and young children, it does not adequately protect adolescents and adults, who account for the majority (>90%) of TB transmission globally.

The Council aims to identify innovative sustainable financing, market solutions and partnerships across public, private, and philanthropic sectors. It will leverage platforms like the African Union, Association of Southeast Asian Nations (ASEAN), BRICS countries (Brazil, Russian Federation, India, China and South Africa), G20, G7 and others to strengthen commitment and actions for novel TB vaccine development and access.

WHO

Download Political Declaration

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