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New WHO recommendations to prevent tuberculosis aim to save millions of lives
Geneva – New World Health Organization (WHO) guidance will help countries accelerate efforts to stop people with tuberculosis (TB) infection becoming sick with TB by giving them preventive treatment.

A quarter of the world‘s population is estimated to be infected with TB bacteria. These people are neither sick nor contagious. However, they are at greater risk of developing TB disease, especially those with weakened immunity. Offering them TB
preventive treatment will not only protect them from becoming sick but also cut down on the risk of transmission in the community.

As we mark World TB Day 2020, the disease remains the world’s top infectious killer. In 2018, 10 million people fell ill with TB worldwide and 1.5 million people lost their lives to this disease.

“COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be,“ said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “The world committed to end TB by 2030; improving prevention is key
to making this happen. Millions of people need to be able to take TB preventive treatment to stop the onset of disease, avert suffering and save lives”.

Dr Tedros highlighted the importance to continue efforts to tackle longstanding health problems, including TB during global outbreaks such as COVID-19. At the same time, programmes already in place to combat TB and other major infectious diseases
can be leveraged to make the response to COVID-19 more effective and rapid.

Although some progress has been made towards targets set at the UN high-level Meeting on TB in 2018, TB preventive treatment has been largely neglected. Global leaders committed to ensuring access to TB preventive treatment to at least 24 million contacts
of people with active TB and 6 million people living with HIV by 2022. To date only a fraction of that target has been reached, with countries putting less than 430,000 contacts and 1.8 million people on TB preventive treatment in 2018.

TB remains the top cause of death among people with HIV. TB preventive treatment works synergistically with antiretroviral therapy to prevent TB and save lives. Reinvigorated efforts by governments, health services, partners, donors and civil society
will be needed to increase access to TB preventive treatment to the levels targeted.

The new consolidated guidelines recommend a range of innovative approaches to scale up access to TB preventive treatment:
- WHO recommends a scale-up of TB preventive treatment among populations at highest risk including household contacts of TB patients, people living with HIV and other people at risk with lowered” immunity or living in crowded settings.
- WHO recommends an integration of TB preventive treatment services into ongoing case finding efforts for active TB. All household contacts of TB patients and people living with HIV are recommended to be screened
  for active TB. If active TB is ruled out, they should be initiated on TB preventive treatment.
- WHO recommends that either a tuberculin skin test or interferon-gamma release assay (IGRA) be used to test for TB infection. Both tests are helpful to find people more likely to benefit from TB preventive treatment
  but should not become a barrier to scale-up access. Testing for TB infection is not required before starting TB preventive treatment in people living with HIV, and children under 5 years who are contacts of people with active TB.
- WHO recommends new shorter options for preventive treatment in addition to the widely used 6 months of daily isoniazid. The shorter options that are now recommended range from a 1 month daily regimen of rifapentine plus isoniazid
  to 3 months weekly rifapentine plus isoniazid, 3 months daily rifampicin plus isoniazid, or 4 months of daily rifampicin alone.
“As people around the globe come together to commemorate World TB Day, WHO is calling on governments, affected communities, civil society organizations, health-care providers, donors, partners and the industry to unite forces and step up
the TB response – notably for TB preventive treatment – to ensure no one is left behind,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. “The new WHO guidance shows the way forward for millions to rapidly
access new tools and shorter, safer options for preventive treatment. The time for action is now.”

TB preventive treatment is an affordable intervention that can prevent families from sliding into poverty and preserve the health and economy of whole communities. WHO anticipates that as new and safer drugs come onto the markets, and as prices
fall, it will become a highly-cost effective way to save millions of lives.

NOTES FOR EDITORS:

WORK BY WHO AND PARTNERS

WHO works closely with Member States including the US Government and technical and funding partners such as UNITAID to enhance access to shorter TB preventive treatment regimens. UNITAID-supported projects such as IMPAACT4TB and Cap-TB projects
enabled by WHO with partners in Brazil, Cambodia, Cameroon, Côte d’Ivoire, Democratic Republic of Congo, Ethiopia, Ghana, India, Indonesia, Kenya, Lesotho, Malawi, Mozambique, South Africa, Uganda, United Republic of Tanzania and
Zimbabwe are leading the way. The new treatment options are also now more affordable, thanks to the significant price drop of rifapentine – a key drug – facilitated recently by UNITAID, the Global Fund to Fight AIDS, Tuberculosis and Malaria
and global biopharmaceutical company Sanofi, along with forthcoming arrangements underway with generic manufacturers.

MORE ABOUT THE GUIDELINES

The new consolidated WHO guidelines come with an operational handbook to help guide countries step-by-step as they take TB preventive treatment to scale. This includes guidance on how to prioritize and invest from demand creation for TB prevention
to supervision and monitoring of the programme.

The guidelines and operational handbook are also accompanied by an innovative mobile application – Prevent TB –to help health-care workers manage TB preventive treatment in their communities. Its online dashboard allows programme
managers to visualize and monitor data in real time. The application can be customized by countries to suit their specific settings and is currently being adopted in India and Philippines.

WORLD TB DAY

The new guidelines and tools are being released ahead of World TB Day. World TB Day is observed on March 24 each year to raise public awareness and understanding about the world’s deadliest infectious killer – TB and its devastating
health, social and economic impact on people around the world. Under the theme “It’s Time”, the spotlight this year is on urgently accelerating the TB response to save lives and end suffering.

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https://www.who.int/news-room/detail/24-03-2020-new-who-recommendations-to-prevent-tuberculosis-aim-to-save-millions-of-lives

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March 24, 2020
Google Analytics: The Top 3 Metrics Every Marketer Should Measure

Growing competition has made it necessary for businesses to be available to their customers all the time. Official websites of the company are one of the most preferred ways in which consumers choose to connect with businesses. This makes it essential for businesses and marketers to understand how exactly their customers use their website and what it is that they are looking for. Getting into these details can help them to a great extent in improving their online presence as well as coming out with online marketing campaigns…

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http://www.associationofmarketing.org/articles/view.php?article_id=14160

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March 22, 2020
New research improves drone detection for increased public safety

Unmanned aerial vehicles (UAV), commonly known as drones, are widely used in mapping, aerial photography, rescue operations, shipping, law enforcement, agriculture, among other things. Despite great potential for improving public safety, use of drones can also lead to very undesirable situations, such as privacy and safety violations, or property damage. There is also the highly concerning matter of drones being harnessed to carry out terrorist attacks, which means a threat to public safety and national security.

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https://techxplore.com/news/2020-03-drone-safety.html

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March 18, 2020
How big data is reshaping aging research and education

The age of big data is here: The world has created more data in the past two years than in the entire previous history of the human race. USC Leonard Davis School of Gerontology researchers are dissecting treasure troves of information—from sources as diverse as brain scans and the human genome—to fuel groundbreaking research on improving how we age, and to reshape gerontology education to enable future scientists to make an impact in a changing field.

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https://techxplore.com/news/2020-03-big-reshaping-aging.html

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March 17, 2020
Data-collection platform improving healthcare globally

Frontline health workers represent the lifeblood of many healthcare systems in low- and middle-income countries around the world. Often overworked and underpaid, these workers operate outside hospital settings to meet the community’s poorest people where they live and work, ensuring healthcare initiatives impact the families that need them most.

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March 9, 2020
Improving the vision of self-driving vehicles

There may be a better way for autonomous vehicles to learn how to drive themselves: by watching humans. With the help of an improved sight-correcting system, self-driving cars could learn just by observing human operators complete the same task.

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March 6, 2020
Data-driven machine learning is the best approach for advanced battery modelling

Demand for electrification of transport has emerged in recent years due to increasing concerns about global warming. The widespread adoption of electric vehicles will result in reduced harmful emissions and cleaner air, among other social and economic benefits. The battery industry is in need of software solutions for battery manufacturers to reduce fabrication and development costs while improving key batteries metrics.

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March 3, 2020
A current map for improving circuit design

A practical method for mapping the flow of a current in devices with complex geometries that could be used to optimize circuit design has been developed at KAUST.

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March 2, 2020
WHO outlines steps to save 7 million lives from cancer

The World Health Organization (WHO) today spells out the need to step up cancer services in low and middle-income countries. WHO warns that, if current trends continue, the world will see a 60% increase in cancer cases over the next two decades. The greatest increase (an estimated 81%) in new cases will occur in low- and middle-income countries, where survival rates are currently lowest.

This is largely because these countries have had to focus limited health resources on combating infectious diseases and improving maternal and child health, while health services are not equipped to prevent, diagnose and treat cancers. In 2019, more than 90% of high-income countries reported that comprehensive treatment services for cancer were available in the public health system compared to less than 15% of low-income countries.

“This is a wake-up call to all of us to tackle the unacceptable inequalities between cancer services in rich and poor countries,” says Dr Ren Minghui, Assistant Director-General, Universal Health Coverage/ Communicable and Noncommunicable Diseases, World Health Organization. “If people have access to primary care and referral systems then cancer can be detected early, treated effectively and cured. Cancer should not be a death sentence for anyone, anywhere.”

Yet, progress in poorer countries is achievable. WHO and the International Agency for Research on Cancer (IARC) are releasing two coordinated reports on World Cancer Day (4 February), in response to government calls for more research into the scope and potential policies and programmes to improve cancer control.

“At least 7 million lives could be saved over the next decade, by identifying the most appropriate science for each country situation, by basing strong cancer responses on universal health coverage, and by mobilizing different stakeholders to work together”, said Dr Tedros Adhanom Ghebreyesus, Director-General, WHO.

WHO highlights a wide range of proven interventions to prevent new cancer cases. These include controlling tobacco use (responsible for 25% of cancer deaths), vaccinating against hepatitis B to prevent liver cancer, eliminating cervical cancer by vaccinating against HPV, screening and treatment, implementing high-impact cancer management interventions that bring value for money and ensuring access to palliative care including pain relief.

“The past 50 years have seen tremendous advances in research on cancer prevention and treatment,” says Dr Elisabete Weiderpass, Director of IARC. “Deaths from cancer have been reduced. High-income countries have adopted prevention, early diagnosis and screening programmes, which together with better treatment, have contributed to an estimated 20% reduction in the probability of premature mortality between 2000 and 2015, but low-income countries only saw a reduction of 5%. We need to see everyone benefitting equally.” The challenge will be for countries to select treatments balancing considerations including cost, feasibility and effectiveness. Each government is tasked with choosing the appropriate innovative cancer therapies, while recognizing that established treatments, many of which are very effective and affordable, can provide benefits for cancer without causing financial hardship.

Note to editors

World Health Organization

Report on Cancer: Setting priorities, investing wisely and providing care for all

The report aims to set the global agenda on cancer, mobilize stakeholders and help countries set priorities for investing in cancer control and universal health coverage. It introduces the principles, tools and current priority cancer control interventions in the context of the current and future cancer burden and opportunities.

International Agency for Research on Cancer

World Cancer Report “Cancer research for cancer prevention”

The report focuses on prevention and offers the most comprehensive overview of relevant research available to date, ranging from descriptive etiology, cellular and molecular biology, toxicology and pathology through to behavioural and social science. Key chapters include discussions on the impact of inequalities in cancer, vaccination and screening, genomic individual susceptibility to cancer and the finer identification of those at risk, which may allow ‘precision cancer prevention’.

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https://www.who.int/news-room/detail/04-02-2020-who-outlines-steps-to-save-7-million-lives-from-cancer

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February 27, 2020
Pregnancy and breastfeeding during an Ebola virus outbreak

Women who are pregnant or breastfeeding in an Ebola outbreak face similar challenges as other population groups, but they have specific health needs which must be met.

As the second largest Ebola outbreak in history continues in the Democratic Republic of Congo, WHO has released new clinical guidelines for healthcare providers supporting pregnant or breastfeeding women in the context of Ebola virus disease.

Improving clinical care and reducing mortality

Clear and coherent guidance is needed to meet the combined needs of women requiring Ebola treatment, pregnancy care and management of complications.

Information on how to protect breastfeeding children and other members in the community from transmission of the disease is also critical.

Limited scientific evidence on how to best manage these needs has previously been a challenge for affected countries. In addition, misconceptions that pregnant women have a higher mortality rate than other populations with Ebola may in some contexts have put pregnant women at risk of not receiving standard care.

WHO’s Guideline on the management of pregnant and breastfeeding women in the context of Ebola virus reviews existing evidence and provides a single set of recommendations on the care continuum for women exposed to, diagnosed with, or recovered from Ebola.

This will enable healthcare providers, emergency response teams and health policy-makers to improve prevention and treatment measures in an Ebola outbreak.

Obstetric care at an Ebola Treatment Centre

Optimal supportive care should be offered to all pregnant women with Ebola. Likewise, they should be offered experimental treatment and vaccination under the same conditions as non-pregnant populations.

Ebola virus disease does increase the risk of miscarriage and early labour, requiring close clinical management at Ebola treatment centres. It is important to engage both obstetric providers and those trained in Ebola response.

This dual expertise is also important because early Ebola and pregnancy-related symptoms can overlap. Pregnant women should be prioritised for testing to confirm an Ebola infection.

Ebola virus can persist in pregnancy related fluids as well as breastmilk. If healthcare providers are not clear on how to manage Ebola infection risk, they may be less willing to provide care. This stigma can be life-threatening for women who experience complications during delivery.

The new WHO guidelines advise healthcare workers on how to protect themselves while caring for pregnant women with Ebola virus disease. This includes induced labour or surgical procedures, which carry greater risk of transmission in cases of acute infection. Any invasive treatments should be carried out in full personal protective equipment.

Breastfeeding recommendations in an Ebola outbreak

WHO recommends that women with suspected or confirmed Ebola immediately stop breastfeeding and are prioritised for diagnostic testing. Any child exposed to Ebola through breast milk should be placed into safe care, closely monitored for symptoms over a 21-day period and fed with an appropriate breast milk substitute.

The guidelines strongly recommend that breastfeeding is only restarted following two consecutive negative tests of breast milk, separated by 24 hours.

A breast milk substitute should be used even if infection is confirmed for both the mother and her child. Exceptions can be made for infants under 6 months of age who are already infected, if breast milk substitutes are not feasible, affordable, sustainable or safe and separation cannot be implemented safely.

Women’s health and rights in a disease outbreak

A disease outbreak does not change women’s and adolescent girls’ fundamental human right to sexual and reproductive healthcare, including evidence-based care during pregnancy and childbirth.

Women need support to make informed reproductive health care choices for themselves and their children. Women living in an Ebola outbreak should have access to all relevant reproductive options, regardless of economic, cultural, racial or religious status, including contraception and safe abortion to the full extent of the law.

Pregnant and breastfeeding women across affected communities need equitable and respectful care that considers the risks they face and supports the choices they make.

Accessing the guidelines and further research

These guidelines are now available online and may be freely downloaded. The executive summary will be available in French.

WHO will closely monitor new data as it emerges, as there is still a pressing need to prioritise ongoing research related to Ebola virus transmission.

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https://www.who.int/news-room/detail/10-02-2020-pregnancy-and-breastfeeding-during-an-ebola-virus-outbreak

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February 27, 2020