"Health is a fundamental human right, and attacks on health care are a blatant violation of that right." Dr Tedros Adhanom Ghebreyesus, Director-General, WHO

World Humanitarian Day 2018 #NotATarget

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"Health is a fundamental human right, and attacks on health care are a blatant violation of that right." Dr Tedros Adhanom Ghebreyesus, Director-General, WHO

Emergencies cause immense suffering for millions of people - often the world's poorest, most marginalized and vulnerable individuals. Humanitarian aid workers, including health care workers strive to provide life-saving assistance and long term rehabilitation to disaster-affected communities, regardless of where they are in the world and without discrimination. On 19 August, World Humanitarian Day brings citizens of the world together to rally support for people living in crises and to pay tribute to the aid workers who help them. Join the #NotATarget movement and demand world leaders do everything in their power to protect all civilians and health care workers in conflict.

INVITATION | How much do we really know about Mindanao? | 9 August 2018 | 3-5 PM | Asian Institute of Management

UNDERSTANDING MINDANAO SERIES: MINDANAO 101

9 August 2018, Thursday
Fuller Hall, 3F Asian Institute of Management, 123 Paseo de Roxas, Makati City

2 PM – Registration

3 PM – Program Start

There are negative stereotypes, biases, and limited view of the people and issues involved in Mindanao. Mindanao is perceived to be marginalized, violent and dangerous, and a place for Muslims. This mindset stems from lack of understanding about the region and the religion. How much do we really know about Mindanao?

Asia Society Philippines cordially invites you to the inaugural Understanding Mindanao Series, to be held on 9 August 2018, 3:00 to 5:00 PM at the Asian Institute of Management.

The Understanding Mindanao Series is a three-part dialogue that aims to provide an environment for inquiry and learning about the region, and to educate the public by developing a common understanding about Mindanao and strengthening relationships with the tri-people community in Mindanao.

This series will discuss the different aspects of Mindanao, and will run from August to October 2018. The first of the three forums, “Mindanao 101” aims to give better understanding of what shapes Mindanao through a discussion of its history, people, and issues.

Due to limited seats, kindly register by clicking here or at understandingmindanao1.eventbrite.com by 8 August 2018.

This event is free of charge and open to the public. Please forward this message to your network, or any parties you think would be interested.

This email serves as your formal invitation. For any questions, please feel free to contact Yeng Rarugal at mrarugal@asiasociety.org or at 550 2612.

Thank you very much and we hope that you will be able to join us on this timely and meaningful event.

Asia Society Philippine Foundation, Inc. | 2F AIM Conference Center, Makati, Philippines | t +632 5502612 | t/f +632 8108983 | www.asiasociety.org/philippines | Hong Kong | Houston | Los Angeles | MANILA | Sydney | Mumbai | New York | San Francisco | Seoul | Shanghai | Tokyo | Washington DC | Zurich

UN chief welcomes new law giving extra autonomy to Muslims in Southern Philippines

27 July 2018

Peace and Security

The UN Secretary-General on Friday welcomed a new law which grants extra autonomy to Muslim communities living in the Southern Philippines, describing it as a “landmark achievement on the road to lasting peace”.

Philippine President, Rodrigo Duterte, signed the new legislation, formally known as the Organic Law for Bangsamoro in the Autonomous Region in Muslim Mindanao, on Thursday, raising hopes that years of separatist violence involving central Government troops and militants from the Moro Islamic Liberation Front, can be brought to an end.

“The Secretary-General congratulates negotiators for the Government of the Philippines and the Moro Islamic Liberation Front, the Bicameral Conference Committee, the Bangsamoro Transition Commission and civil society groups for their efforts,” said the UN chief, in a statement issued by his Spokesperson, Stéphane Dujarric.

According to news reports, the long-anticipated new autonomy came four years after the Government signed a peace deal with the separatist group, which dropped its bid for full independence, seeking instead a new deal over self-rule.

The Front began its uprising in 1978, marking a period of violent confrontation which left around 120,000 dead. The new expanded autonomous region in the south, will be led initially by a transitional authority, before being run by a new parliamentary body, say reports.

The statement from the UN chief said that the UN “will continue to support the Philippines in the implementation of the law, and to help build the capacity of the Bangsamoro Transition Authority as an effective conduit for peace, democratic governance, and human rights”.

Why is antimicrobial resistance a global concern? -WHO

Antimicrobial resistance is putting the gains of the Millennium Development Goals at risk and endangers the achievement of the Sustainable Development Goals. 
New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases, resulting in prolonged illness, disability, and death.

Antimicrobial resistance increases the cost of healthcare with lengthier stays in hospitals and more intensive care required.

Without effective antimicrobials for prevention and treatment of infections, medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery (for example, caesarean sections or hip replacements) become very high risk.



What accelerates the emergence and spread of antimicrobial resistance?
Antimicrobial resistance occurs naturally over time, usually through genetic changes. However, the misuse and overuse of antimicrobials is accelerating this process. In many places, antibiotics are overused and misused in people and animals, and often given without professional oversight. Examples of misuse include when they are taken by people with viral infections like colds and flu, and when they are given as growth promoters in animals or used to prevent diseases in healthy animals.

Antimicrobial resistant-microbes are found in people, animals, food, and the environment (in water, soil and air). They can spread between people and animals, including from food of animal origin, and from person to person. Poor infection control, inadequate sanitary conditions and inappropriate food-handling encourage the spread of antimicrobial resistance.


Key facts Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.
AMR is an increasingly serious threat to global public health that requires action across all government sectors and society.
Without effective antibiotics, the success of major surgery and cancer chemotherapy would be compromised.
The cost of health care for patients with resistant infections is higher than care for patients with non-resistant infections due to longer duration of illness, additional tests and use of more expensive drugs.
In 2016, 490 000 people developed multi-drug resistant TB globally, and drug resistance is starting to complicate the fight against HIV and malaria, as well.

Antimicrobial resistance happens when microorganisms (such as bacteria, fungi, viruses, and parasites) change when they are exposed to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics). Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.

As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.




Present situation
Resistance in bacteria

Antibiotic resistance is present in every country.

Patients with infections caused by drug-resistant bacteria are at increased risk of worse clinical outcomes and death, and consume more health-care resources than patients infected with non-resistant strains of the same bacteria.

Resistance in Klebsiella pneumoniae – common intestinal bacteria that can cause life-threatening infections – to a last resort treatment (carbapenem antibiotics) has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, and infections in newborns and intensive-care unit patients. In some countries, because of resistance, carbapenem antibiotics do not work in more than half of people treated for K. pneumoniae infections.

Resistance in E. coli to one of the most widely used medicines for the treatment of urinary tract infections (fluoroquinolone antibiotics) is very widespread. There are countries in many parts of the world where this treatment is now ineffective in more than half of patients.

Treatment failure to the last resort of medicine for gonorrhoea (third generation cephalosporin antibiotics) has been confirmed in at least 10 countries (Australia, Austria, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom of Great Britain and Northern Ireland).

WHO recently updated the treatment guidelines for gonorrhoea to address emerging resistance. The new WHO guidelines do not recommend quinolones (a class of antibiotic) for the treatment of gonorrhoea due to widespread high levels of resistance. In addition, treatment guidelines for chlamydial infections and syphilis were also updated.

Resistance to first-line drugs to treat infections caused by Staphlylococcus aureus—a common cause of severe infections in health facilities and the community—is widespread. People with MRSA (methicillin-resistant Staphylococcus aureus) are estimated to be 64% more likely to die than people with a non-resistant form of the infection.

Colistin is the last resort treatment for life-threatening infections caused by Enterobacteriaceae which are resistant to carbapenems. Resistance to colistin has recently been detected in several countries and regions, making infections caused by such bacteria untreatable.

Resistance in tuberculosis (TB)

WHO estimates that, in 2014, there were about 480 000 new cases of multidrug-resistant tuberculosis (MDR-TB), a form of tuberculosis that is resistant to the 2 most powerful anti-TB drugs. Only about a quarter of these (123 000 cases) were detected and reported. MDR-TB requires treatment courses that are much longer and less effective than those for non-resistant TB. Globally, only half of MDR-TB patients were successfully treated in 2014.

Among new TB cases in 2014, an estimated 3.3% were multidrug-resistant. The proportion is higher among people previously treated for TB, at 20%.

Extensively drug-resistant tuberculosis (XDR-TB), a form of tuberculosis that is resistant to at least 4 of the core anti-TB drugs, has been identified in 105 countries. An estimated 9.7% of people with MDR-TB have XDR-TB.

Resistance in malaria

As of July 2016, resistance to the first-line treatment for P. falciparum malaria (artemisinin-based combination therapies, also known as ACTs) has been confirmed in 5 countries of the Greater Mekong subregion (Cambodia, the Lao People’s Democratic Republic, Myanmar, Thailand and Viet Nam). In most places, patients with artemisinin-resistant infections recover fully after treatment, provided that they are treated with an ACT containing an effective partner drug. However, along the Cambodia-Thailand border, P. falciparum has become resistant to almost all available antimalarial medicines, making treatment more challenging and requiring close monitoring. There is a real risk that multidrug resistance will soon emerge in other parts of the subregion as well.The spread of resistant strains to other parts of the world could pose a major public health challenge and jeopardize important recent gains in malaria control.

A "WHO Strategy for Malaria Elimination in the Greater Mekong subregion (2015-2030)" was endorsed by all 5 countries, as well as China.

Resistance in HIV

In 2010, an estimated 7% of people starting antiretroviral therapy (ART) in developing countries had drug-resistant HIV. In developed countries, the same figure was 10–20%. Some countries have recently reported levels at or above 15% amongst those starting HIV treatment, and up to 40% among people re-starting treatment. This requires urgent attention.

Increasing levels of resistance have important economic implications as second and third-line regimens are 3 times and 18 times more expensive, respectively, than first-line drugs.

Since September 2015, WHO has recommended that everyone living with HIV start on antiretroviral treatment . Greater use of ART is expected to further increase ART resistance in all regions of the world. To maximize the long-term effectiveness of first-line ART regimens, and to ensure that people are taking the most effective regimen, it is essential to continue monitoring resistance and to minimize its further emergence and spread. In consultation with countries, partners and stakeholders, WHO is currently developing a new "Global Action Plan for HIV Drug Resistance (2017-2021)".

Resistance in influenza

Antiviral drugs are important for treatment of epidemic and pandemic influenza. So far, virtually all influenza A viruses circulating in humans were resistant to one category of antiviral drugs – M2 Inhibitors (amantadine and rimantadine). However, the frequency of resistance to the neuraminidase inhibitor oseltamivir remains low (1-2%). Antiviral susceptibility is constantly monitored through the WHO Global Influenza Surveillance and Response System.

Need for coordinated action

Antimicrobial resistance is a complex problem that affects all of society and is driven by many interconnected factors. Single, isolated interventions have limited impact. Coordinated action is required to minimize the emergence and spread of antimicrobial resistance.

All countries need national action plans on AMR.
Greater innovation and investment are required in research and development of new antimicrobial medicines, vaccines, and diagnostic tools.

WHO response

WHO is providing technical assistance to help countries develop their national action plans, and strengthen their health and surveillance systems so that they can prevent and manage antimicrobial resistance. It is collaborating with partners to strengthen the evidence base and develop new responses to this global threat.

WHO is working closely with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE) in a ‘One Health’ approach to promote best practices to avoid the emergence and spread of antibiotic resistance, including optimal use of antibiotics in both humans and animals.

A political declaration endorsed by Heads of State at the United Nations General Assembly in New York in September 2016 signaled the world’s commitment to taking a broad, coordinated approach to address the root causes of antimicrobial resistance across multiple sectors, especially human health, animal health and agriculture. WHO is supporting Member States to develop national action plans on antimicrobial resistance, based on the global action plan.

WHO has been leading multiple initiatives to address antimicrobial resistance:

World Antibiotic Awareness Week

Held every November since 2015 with the theme “Antibiotics: Handle with care”, the global, multi-year campaign has increasing volume of activities during the week of the campaign.

The Global Antimicrobial Resistance Surveillance System (GLASS)

The WHO-supported system supports a standardized approach to the collection, analysis and sharing of data related to antimicrobial resistance at a global level to inform decision-making, drive local, national and regional action.

Global Antibiotic Research and Development Partnership (GARDP)

A joint initiative of WHO and Drugs for Neglected Diseases initiative (DNDi), GARDP encourages research and development through public-private partnerships. By 2023, the partnership aims to develop and deliver up to four new treatments, through improvement of existing antibiotics and acceleration of the entry of new antibiotic drugs.

Interagency Coordination Group on Antimicrobial Resistance (IACG)

The United Nations Secretary-General has established IACG to improve coordination between international organizations and to ensure effective global action against this threat to health security. The IACG is co-chaired by the UN Deputy Secretary-General and the Director General of WHO and comprises high level representatives of relevant UN agencies, other international organizations, and individual experts across different sectors.




Highlight


Global action plan
Global report on surveillance
Country situation analysis
Policy to combat antimicrobial resistance
More on antimicrobial resistance

Source: http://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance

Countries step up to tackle antimicrobial resistance

Global Action Plan on Antimicrobial Resistance - message from WHO Director-General

Countries are making significant steps in tackling antimicrobial resistance (AMR), but  serious gaps remain and require  urgent action, according to a report released today by the Food and Agriculture Organization of the United Nations (FAO), World Organisation for Animal Health (OIE) and the World Health Organization (WHO).

The report charts progress in 154 countries and reveals  wide discrepancies.  Some, including many European countries, have been working on  AMR policies in human and animal sectors for more than 4 decades. Others have only recently started to take action to contain this growing threat. Progress in developing and implementing plans is greater in high-income than low-income countries but all countries have scope for improvement. No country  reports sustained capacity at scale in all areas.

The report looks at surveillance, education, monitoring and regulating consumption and use of antimicrobials in human health, animal health and production, as well as plants and the environment – as recommended in the Global Action Plan published in 2015.

Promising findings include 105 countries with a surveillance system in place for reporting drug-resistant infections in human health and 68 countries with a system for tracking consumption of antimicrobials.  In addition, 123 countries reported that they have policies to regulate the sale of antimicrobials, including the requirement of a prescription for human use – a key measure to tackle overuse and misuse of antimicrobials. 

But implementation of these policies varies  and unregulated medicines are still available in places such as street markets, with no limits on how they are used. Medicines are very often sold over the counter and no prescription is requested. This puts human and animal health at risk, potentially contributing to the development of antimicrobial resistance.

The report highlights areas,  particularly in the animal and food sectors, where there is an urgent need for more investment and action. For example, only 64 countries report that they follow FAO-OIE-WHO recommendations to limit the use of critically important antimicrobials for growth promotion in animal production. Of these, 39 are high-income countries, with the majority in WHO’s European Region. By contrast, only 3 countries from WHO’s African Region and 7 countries from the WHO Region of the Americas have taken this important step to reduce the emergence of antimicrobial resistance.

A total of 67 countries report at least having legislation in place to control all aspects of production, licensing and distribution of antimicrobials for use in animals. But 56 either said that they had  no national policy or legislation regarding the quality, safety and efficacy of antimicrobial products used in animal and plant health, and their distribution, sale or use, or that they were unable to report whether they have these policies in place.

There is also a substantial lack of action and data in  the environment and plant sectors. Although 78 countries have regulations in place to prevent environmental contamination generally, only 10 of them report having comprehensive systems to ensure regulatory compliance for all waste management, including regulations that limit the discharge of antimicrobial residues into the environment. This is insufficient to protect the environment from the hazards of antimicrobial production.

“This report shows growing global momentum to combat antimicrobial resistance,” says Dr Ranieri Guerra, Assistant Director-General for Antimicrobial Resistance at WHO. “We call on governments to make sustained commitments across all sectors  –  human and animal health, plant health and the environment – otherwise we risk losing the use of these precious medicines.”

“Supporting low- and middle-income countries to follow guidance of responsible and prudent use of antimicrobials in animals is an urgent priority,” says Dr Matthew Stone, Deputy Director General of the World Organisation for Animal Health (OIE).  “Implementation of dedicated OIE international standards, appropriate national legislation and strengthening of veterinary services are essential steps to help all animal health stakeholders contribute to controlling the threat posed by antimicrobial resistance.”

“FAO welcomes that many countries are taking concrete steps towards the responsible use of antimicrobials in agriculture,” says Maria Helena Semedo, FAO Deputy Director-General. “However, countries need to do more to reduce the unregulated and excessive use of antimicrobials in agriculture.  We particularly urge countries to phase out the use of antimicrobials for growth promotion in animal production – terrestrial and aquatic.”

From this survey and other sources, the Tripartite (FAO, OIE and WHO) is aware that 100 countries now have national action plans for AMR in place and a further 51 countries have plans under development, but more needs to be done to ensure that they are implemented. Only 53 countries report that they have a multisectoral working group that is fully functional, although a further 77 have established such a group. Only 10 countries report that the funding for all actions in the plan is identified and many middle- and low-income countries may need long-term development assistance to implement their plans effectively and sustainably. Positively, among the top ten chicken-, pork- and cattle-producing countries that responded to the AMR survey, 9 out of 10 have at minimum developed a national action plan; the majority of these have plans in operation with a monitoring arrangement.  

About the survey

The global Tripartite survey of country progress in addressing AMR is part of monitoring implementation of the Global Action Plan on AMR, which was endorsed by WHO and FAO Member States, and OIE Member Countries in 2015.

The survey is developed and issued jointly by the three Organizations and the report analyses the data from year two of the survey.

The 2018 survey received responses from 154 countries (out of 194 of WHO Member States contacted). All countries’ responses from both years are published in an open-access database, offering scope for in-country review with civil society and other stakeholders.

For more information:

Link to database and report: http://www.who.int/antimicrobial-resistance/global-action-plan/database/en/

18 July 2018 

News Release

http://www.who.int/news-room/detail/18-07-2018-countries-step-up-to-tackle-antimicrobial-resistance

Health Ministers and representatives from many organizations working to improve health are gathered in Geneva this week for the World Health Assembly. Today, delegates agreed on WHO’s new strategic plan of work for the next five years. Other issues for discussion include influenza, cholera, tuberculosis, snakebite, physical activity, polio and access to essential medicines. World Health Assembly is attended by delegates from WHO Member States as well as representatives from many agencies, organizations, foundations and other groups that contribute to improving public health. Member States approve resolutions in committee before formally adopting them in the plenary session at the end of the Health Assembly, today, 26 May.

World Health Assembly delegates agree new five-year strategic plan -23 May 2018 News Release Geneva. World Health Assembly delegates agreed an ambitious new strategic plan for the next five years. The Organization’s 13th General Programme of Work (GPW) is designed to help the world achieve the Sustainable Development Goals – with a particular focus on SDG3: ensuring healthy lives and promoting wellbeing for all at all ages by 2030.

It sets three targets: to ensure that by 2023, 1 billion more people benefit from universal health coverage; 1 billion more people are better protected from health emergencies; and 1 billion more people enjoy better health and wellbeing. WHO estimates that achieving this “triple billion” target could save 29 million lives.

Speaking to the Health Assembly, Director-General, Dr Tedros Adhanom Ghebreyesus told delegates that the new strategic plan was ambitious because "it must be".

Delegates noted that the Organization will need to make a number of strategic shifts in order to achieve these targets, notably to step up its public health leadership; focus on impact in countries; and ensure that people can access authoritative and strategic information on matters that affect people’s health.
Key topics during this Health Assembly

Today, the debate turns to WHO’s work in emergencies. Over the coming days, delegates will make decisions relating to the International Health Regulations (2005), the Pandemic Influenza Preparedness Framework, noncommunicable diseases (NCDs); cholera, tuberculosis; snakebite; physical activity; digital health; assistive technology; polio virus; and health conditions in the occupied Palestine territory. The Health Assembly will also discuss other topics including: access to essential medicines and vaccine and women’s, children’s and adolescent’s health.

First-ever WHO list of essential diagnostic tests to improve diagnosis and treatment outcomes 15 May 2018 News Release Geneva

Today, many people are unable to get tested for diseases because they cannot access diagnostic services. Many are incorrectly diagnosed. As a result, they do not receive the treatment they need and, in some cases, may actually receive the wrong treatment.

For example, an estimated 46% of adults with Type 2 diabetes worldwide are undiagnosed, risking serious health complications and higher health costs. Late diagnosis of infectious diseases such as HIV and tuberculosis increases the risk of spread and makes them more difficult to treat.

To address this gap, WHO today published its first Essential Diagnostics List, a catalogue of the tests needed to diagnose the most common conditions as well as a number of global priority diseases.

“An accurate diagnosis is the first step to getting effective treatment,” says Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “No one should suffer or die because of a lack of diagnostic services, or because the right tests were not available.”

The list concentrates on in vitro tests - i.e. tests of human specimens like blood and urine. It contains 113 products: 58 tests are listed for detection and diagnosis of a wide range of common conditions, providing an essential package that can form the basis for screening and management of patients.  The remaining 55 tests are designed for the detection, diagnosis and monitoring of “priority” diseases such as HIV, tuberculosis, malaria, hepatitis B and C, human papillomavirus and syphilis. 

Some of the tests are particularly suitable for primary health care facilities, where laboratory services are often poorly resourced and sometimes non-existent; for example, tests that can rapidly diagnose a child for acute malaria or glucometers to test diabetes.  These tests do not require electricity or trained personnel.  Other tests are more sophisticated and therefore intended for larger medical facilities.

“Our aim is to provide a tool that can be useful to all countries, to test and treat better, but also to use health funds more efficiently by concentrating on the truly essential tests,” says Mariângela Simão, WHO Assistant Director-General for Access to Medicines, Vaccines and Pharmaceuticals. “Our other goal is to signal to countries and developers that the tests in the list must be of good quality, safe and affordable.”

For each category of test, the Essential Diagnostics List specifies the type of test and intended use, format, and if appropriate for primary health care or for health facilities with laboratories. The list also provides links to WHO Guidelines or publications and, when available, to prequalified products.

Similar to the WHO Essential Medicines List, which has been in use for four decades, the Essential Diagnostics List is intended to serve as a reference for countries to update or develop their own list of essential diagnostics. In order to truly benefit patients, national governments will need to ensure appropriate and quality-assured supplies, training of health care workers and safe use. To that end, WHO will provide support to countries as they adapt the list to the local context.

The Essential Diagnostics List was developed following an extensive consultation within WHO and externally. The draft list was then considered for review by WHO’s Strategic Advisory Group of Experts on In-Vitro Diagnostics – a group of 19 experts with global representation.

WHO will update the Essential Diagnostics List on a regular basis. 

In the coming months, WHO will issue a call for applications to add categories to the next edition. The list will expand significantly over the next few years, as it incorporates other important areas including antimicrobial resistance, emerging pathogens, neglected tropical diseases and additional noncommunicable diseases.

List of essential diagnostics

List of essential diagnostics
http://www.who.int/medical_devices/diagnostics/EDL_ExecutiveSummary_15may.pdf