Global Digital Store – Ebooks and Softwares

Tag: Include

Legal Issues Arising From Management Of Covid-19 Patients By Ahmed Adetola-Kazeem

A lot of legal issues are bound to arise as an aftermath of the outbreak of Coronavirus otherwise referred to as COVID-19. There is therefore a need to shed light on some of the issues that may arise and how to navigate them. This article will x-ray the rights of patients, the rights of health workers and the basic minimum obligations of the government.

The Code of Medical Ethics in Nigeria 2008 lists acts that constitute professional negligence. Rule 29.4 of the Code outlines some of these acts as follows:-

a)      Failure to attend promptly to a patient requiring urgent attention when the practitioner was in a position to do so;

b)     Manifesting incompetence in the assessment of a patient;

c)      Making an incorrect diagnosis particularly when the clinical features were so glaring that no reasonable skillful practitioner could have failed to notice them;

d)     Failure to advise, or proffering wrong advice to a patient on the risk involved in a particular operation or course of treatment, especially if such an operation or course of treatment is likely to result in serious side effects like deformity or loss of organ, or function;

e)      Failure to obtain the informed consent of the patient before proceeding on any surgical procedure or course of treatment when such consent was necessary;

f)       Making a mistake in treatment e.g. amputation of the wrong limb, carelessness that results in the termination of a pregnancy, prescribing the wrong drug, or dosage in error for a correctly diagnosed ailment, etc;

g)     Failure to refer, or transfer a patient in good time, when such a referral or transfer was necessary;

h)     Failure to do anything that ought reasonably to have been done under any circumstance for the good of the patient;

i)       Failure to see a patient as often as his medical condition warrants or to make appropriate comments in the case notes of the practitioner’s observations and prescribed treatment during such visits. It also includes failure to communicate with the patient or with his relatives as may be necessary with regards to any developments, progress or prognosis in the patient’s condition.

Rule 11.2 of the 2008 Code of Medical Ethics in Nigeria provides that, “A physician shall preserve absolute confidentiality on all he knows about his patient even after the patient has died.”

             Rule 44 of the Code of Medical Ethics has extensive provisions on Confidentiality and when disclosure of information can be made. The Rule provides in part that:

“Disclosure of information on the patient by the doctor can only be made following an informed consent of the patient in writing. It is clear that the ethic covers even such information as induced abortion, venereal disease, attempted suicide, concealed birth and drug dependence but would exclude situations in which a discretionary breach of confidentiality is necessary to protect the patient or the community from danger and this must be made clear to the patient at the time of the confidential disclosure. Where statutory notification of disease is involved, the consent of the patient is not required.”

            Confidentiality: To Disclose Identity Of Covid-19 Patients Or Not To Disclose?

COVID-19 is an infectious disease caused by a newly discovered coronavirus. Most people infected with the COVID-19 will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.[1]

The Federal Ministry of Health confirmed the first case of COVID-19 in Nigeria on the 27th of February 2020. It is the case of an Italian citizen who works in Nigeria and returned from Milan, Italy to Lagos, Nigeria on the 25th of February 2020. In reaction to the report, the social was divided between those who want the name of the Italian disclosed and those that preferred it remains confidential. The outcry was even more when the Chief of Staff to the President tested positive according to reports from various media houses[2], but the Minister of Health decided to keep mute on the identity of the President’s aide who contacted the virus, citing confidentiality.

It will ordinarily be wrong to disclose the medical status of someone infected with COVID-19, for instancethe case of the Italian who was the index case. However in view of the proviso to Rule 44 of the Code of Medical Ethics 2008 which provides that a discretionary breach of confidentiality is necessary in order to protect the community from danger, I am of the view that the test results of popular figures who hold strategic offices like the Chief of Staff to the President or a Governor must be disclosed to guaranty public safety. This is necessary in view of the countless number of people from all works of life they come in contact with on a daily basis. It will be correct to have made their status public in the overriding interest of the public, since it will enable those who have come in contact with them isolate, just like we have seen in the cases of the British Prime Minister, the Bauchi State Govenor, Prince Charles, the First Lady of Canada and many more. We must commend those who announced their status in public themselves-it is the best thing to do in the interest of humanity

The World Health Organization (WHO) provides additional guidelines for the management of coronavirus patients specifically.[3]

Health workers should:

•follow established occupational safety and health procedures, avoid exposing others to health and safety risks and participate in employer-provided occupational safety and health training;

•use provided protocols to assess, triage and treat patients;

•treat patients with respect, compassion and dignity;

•maintain patient confidentiality;

•swiftly follow established public health reporting procedures of suspect and confirmed cases;

•provide or reinforce accurate infection prevention and control and public health information, including to concerned people who have neither symptoms nor risk;

•put on, use, take off and dispose of personal protective equipment properly;

•self-monitor for signs of illness and self-isolate or report illness to managers, if it occurs;

•advise management if they are experiencing signs of undue stress or mental health challenges that require support interventions; and

•report to their immediate supervisor any situation which they have reasonable justification to believe presents an imminent and serious danger to life or health.

Doctors and health workers in Nigeria must endeavor to digest the guidelines in the Code of Medical Ethics as well as the WHO Guidelines for management of Coronavirus victims and ensure they work strictly by their provisions. A breach of these duties have dire consequences.

Options Available To Covid-19 Patients Who Are Victims Of Medical Negligence

A Coronavirus patient who has suffered medical negligence has a number of options:

1. He could file a complaint with the regulatory body (e.g. the Medical and Dental Council of Nigeria, in the cases involving a Doctor). The Doctor will in the first instance be investigated by the Medical and Dental Practitioners Investigation Panel, after which he will be tried by the Medical and Dental Practitioners Disciplinary Tribunal. If found culpable, the Doctor may be warned, suspended from practicing for a period not exceeding 6 months or in very serious cases, have his name can be removed from the Register of Medical Practitioners. The Medical and Dental Practitioners’ Disciplinary Tribunal does not award monetary damages.

2. A suit can be filed against the Medical Doctor, the Hospital, Agency or Government in the High Court for Medical Negligence and monetary damages will be awarded if the Defendant(s) are found culpable.

      3. If there is an element of Crime, a report could be made to the Police who would conduct Criminal Investigation and where the investigation reveals gross negligence, recklessness or wanton disregard for life of the victim, the police can prosecute or forward the case file to the office of the Attorney General of the State for possible prosecution in deserving cases.

A Need To Do More For Doctors And Other Professionals In The Health Sector

Health workers are at the front line of any outbreak response and as such are exposed to hazards that put them at risk of infection with an outbreak pathogen (in this case COVID-19). Hazards include pathogen exposure, long working hours, psychological distress, fatigue, occupational burnout, stigma, and physical and psychological violence.

During the outbreak of Ebola more than 500 health care workers died in Guinea, Liberia and Sierra-Leone alone. We also lost some of our finest doctors and health workers to the disease in Nigeria, the most prominent being Dr. Stella Adadevoh, who is credited with having curbed a wider spread of the Ebola virus in Nigeria by placing the index patient, Patrick Sawyer, in quarantine despite pressures from the Liberian government. As we speak, The coronavirus is waging a war of attrition against health care workers throughout the world, but nowhere is it winning more battles at the moment than in Italy and in Spain, where protective equipment and tests have been in severely short supply for weeks. In Spain 13.6% (6500) of those affected with the coronavirus are health workers and in Italy 10% (7400) of those affected with the virus are health workers. [4] In New York dozens of health workers have been affected with the virus, while hundreds are in quarantine.[5] According to reports filtering in as the time of concluding this article, three health workers have been infected with COVID-19 in Abuja, Nigeria.[6]

Human Rights Watch research into health system collapse in Hungary and Venezuela suggests the nations’ mismanaged, underfunded, and understaffed public healthcare system is poorly equipped to handle a COVID-19 outbreak. Patients and medical experts described a lack of basic hygiene protocol, lack of isolation rooms, and a shortage of health professionals, doctors and nurses, and medical supplies in general.

The situation is not too different in Nigeria at the moment and except something drastic is done we might be witnessing a devastating effect of the pandemic. Nigeria’s, public health capacity has been diminished by large scale public sector corruption. Medical personnel lack surgical masks and local supplies have been diverted and shipped to other markets partly due to corruption. Many states are ill-prepared to combat the impeding surge in patients. A senior health worker with a government hospital in Abuja, in an interview with Sahara Reporters, lamented the lack of quality Personal Protective Equipment for them, adding that government must invest in the protection of health workers at the frontline of the battle against the virus. He said, “The unfortunate thing is that the government is not providing us with what to work with. It is sad that our PPE are not up to the world standard and can be penetrated by viruses. Some of us (health workers) have to use our personal funds to purchase gloves as we do not trust the ones government supplied. Nigerians should please remember us in their prayers and government should provide us with what we really need to work.” [7]

There was report that in Bauchi State a Coronavirus patient rejected the isolation centre at the Bauchi Specialist Hospital and went back home while describing it as “too dirty”.[8]

It is disappointing to hear that the hazard allowance for doctors and health workers is N5,000 per month in Nigeria. The amount is very paltry compared to the risks and the attendant emotional and psychological stress suffered by the health-care workers (HWCs) particularly during monumental outbreaks like this. Unfortunately, when a patient is mismanaged, these doctors and health workers bear the burden of paying huge compensation and sometimes losing their jobs. More importantly, the brain-drain in the health sector is monumental, almost all my friends who are doctors, work abroad. Unfortunately, there are concerted efforts by the US Government to engage foreign Doctors to further fortify its health work force as COVID-19 ravages. Many young Nigerian doctors are already considering the offers because the Nigerian government has paid little attention to their welfare and the welfare of the general health workforce. To stop the exodus of our doctors, who are already in short supply, the government must act fast by improving their welfare packages in line with acceptable international standards.

The psychological needs of doctors and health workers are also often ignored. Unsafe working conditions contribute to health worker attrition in many countries due to work-related illness and injury and the resulting fear of health workers of occupational infection, including from HIV and Tuberculosis. The 2006 World Health Report – Working Together for Health reported on a severe health workforce crisis in fifty-seven countries, most of them in Africa and Asia. [9]

Protecting the occupational health of health workers is critical to having an adequate workforce of trained and healthy health personnel. Governments at the Federal and State levels are urged to do more by complying fully with the World Health Organization’s guidelines regarding the Rights of Health Workers while combating COVID-19. Some of the rights are:

·         assume overall responsibility to ensure that all necessary preventive and protective measures are taken to minimize occupational safety and health risks;

·         provide information, instruction and training on occupational safety and health, including; Refresher training on infection prevention and control(IPC); and Use, putting on, taking off and disposal of personal protective equipment(PPE);

·         provide adequate IPC and PPE supplies (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies) in sufficient quantity to healthcare or other staff caring for suspected or confirmed COVID-19 patients, such that workers do not incur expenses for occupational safety and health requirements;

·         not be required to return to a work situation where there is continuing orserious danger to life or health, until the employer has taken any necessary remedial action;

·         allow workers to exercise the right to remove themselves from a work situation that they have reasonable justification to believe presents an imminent and serious danger to their life or health. When a health worker exercises this right, they shall be protected from any undue consequences;

·         honour the right to compensation, rehabilitation and curative services if infected with COVID-19 following exposure in the workplace. This would be considered occupational exposure and resulting illness would be considered an occupational disease,

·         provide access to mental health and counselling resources; and

·         enable co-operation between management and workers and/or their representatives. Etc.

In conclusion, professional care givers for COVID-19 patients should uphold four basic principles formulated by Beauchamp and Childress in their book ‘Principles of Biomedical Ethics’ in order to protect themselves from liability for negligence. The four basic principles are autonomy, beneficence, non-maleficence and justice.

Autonomy: People have the right to control what happens to their bodies. This principle simply means that an informed, competent adult patient can refuse or accept treatments, drugs, and surgeries according to their wishes. People have the right to control what happens to their bodies because they are free and rational. And these decisions must be respected by everyone, even if those decisions aren’t in the best interest of the patient.

Beneficence: All healthcare providers must strive to improve their patient’s health, to do the most good for the patient in every situation. But what is good for one patient may not be good for another, so each situation should be considered individually. And other values that might conflict with beneficence may need to be considered.

Non-maleficence: “First, do no harm” is the bedrock of medical ethics. In every situation, healthcare providers should avoid causing harm to their patients. You should also be aware of the doctrine of double effect, where a treatment intended for good unintentionally causes harm. This doctrine helps you make difficult decisions about whether actions with double effects can be undertaken.

Justice: The fourth principle demands that you should try to be as fair as possible when offering treatments to patients and allocating scarce medical resources. You should be able to justify your actions in every situation. For instance, it will amount to a professional misconduct for a Health-care Worker to remove a poor man from the ventilator because a Senator was rushed in.

Ahmed Adetola-Kazeem is a partner in Adetola-Kazeem Legal Practice and specializes in Medical and Health Law

Email: aadetolakazeem@gmail.com;aadetolakazeem@gaklp.com

[1] https://www.who.int/health-topics/coronavirus#tab=tab_1(Accessed on the 28th of March 2020)

[2] https://businessday.ng/coronavirus/article/abba-kyari-tests-positive-for-coronavirus-buhari-negative/

https://www.channelstv.com/2020/03/24/buharis-chief-of-staff-abba-kyari-reportedly-tests-positive-for-coronavirus/ (Accessed on the 28th of March 2020)

[3] Coronavirus Disease (Covid-19) Outbreak: Rights, Roles and Responsibilities Of Health workers, Including Key Considerations For Occupational Safety And Health”. https://www.who.int/docs/default-source/coronaviruse/who-rights-roles-respon-hw-covid-19.pdf?sfvrsn=bcabd401_0   (Accessed on the 26th of March 2020)

[4] https://abcnews.go.com/Health/wireStory/collapsing-virus-pummels-medics-spain-italy-69789413 (Accessed on 26th March 2020)

[5] https://www.washingtonpost.com/health/covid-19-hits-doctors-nurses-emts-threatening-health-system/2020/03/17/f21147e8-67aa-11ea-b313-df458622c2cc_story.html (Accessed on 28th of March 2020)

[6] http://saharareporters.com/2020/03/28/exclusive-two-nurses-one-doctor-infected-coronavirus-abuja-hospital

[7] Supra

[8] https://www.dailytrust.com.ng/coronavirus-patient-rejects-bauchi-isolation-centre-returns-home.html (Accessed on 28th March 2020)

[9] https://www.who.int/occupational_health/topics/hcworkers/en/(Accessed on 26th March 2020)

Opinion

AddThis

:

Original Author

:

Ahmed Adetola-Kazeem

Disable advertisements

:

Read More
http://saharareporters.com/2020/04/01/legal-issues-arising-management-covid-19-patients-ahmed-adetola-kazeem

Views: 0

April 2, 2020
IGP, Police Spokesperson, 10 Others Test Negative For Coronavirus

IGP Mohammed Adamu

IGP Mohammed Adamu

IGP, Police Spokesperson, 10 Others Test Negative For Coronavirus

Nigeria’s Inspector-General of Police, Mohammed Adamu, has tested negative for Coronavirus.

The IGP received the result of the test on Tuesday after submitting samples on March 27, 2020.

Other officers, who also tested negative include Force Public Relations Officer, DCP Frank Mba, Principal Staff Officer to the IGP, DCP Idowu Owohunwa, Head of the Force Technical Intelligence Unit, DCP Lanre Ogunlowo, Personal Physician to the IGP, CSP (Dr) Nonye Welle, Medical Officer, Police Clinic, Force Headquarters, Abuja, CSP (Dr) Titus Adegbite, Secretary to the IGP, SP Moses Jolugbo, and five other close aides to Adamu.

While noting that policing was a high-contact job with its attendant risks, the IGP enjoined police officers nationwide to adhere strictly to all precautionary and safety measures in the course of their day-to-day activities.

Adamu, according to a statement by Mba, equally enjoined members of the public to voluntarily obey all restriction orders put in place by government.

Recall that Chief of Staff to President Muhammadu Buhari, Abba Kyari, who has tested positive for Coronavirus, earlier this month attended the wedding of the son of the IGP, thereby raising fears that all those he came in contact with including Adamu may have been infected.

Three of Kyari’s staff were later confirmed to be infected with the virus, leaving several others concerned.

Nigeria currently has 135 confirmed cases of Coronavirus and two recorded deaths.

Police

Poverty

News

AddThis

:

Original Author

:

Saharareporters, New York

Disable advertisements

:

Read More
http://saharareporters.com/2020/03/31/igp-police-spokesperson-10-others-test-negative-coronavirus

Views: 0

April 1, 2020
Nigerian Army Redeploys Senior Officers In Major Shake-up

As earlier reported by SaharaReporters, the Nigerian Army has announced the redeployment of senior officers, claiming that the move was in a bid to add freshness into the war against terrorism in the country.

The posting, which was approved by the Chief of Army Staff, Lt Gen Tukur Yusuf Buratai, led to the removal of Maj. Gen. Olusegun Adeniyi as Theatre Command Operation LAFIYA DOLE, the group fighting Boko Haram terrorists in the North-East region of the country.

Adeniyi, who spoke out against the lack of weapons and accurate intelligence to fight terrorists in the region in a video that went viral a few days ago, was moved to the Nigerian Army Resource Centre as Senior Research Fellow after his outburst embarrassed the military authorities.

See Also

Breaking News

BREAKING: Nigerian Army Removes General In Viral Video Asking For Weapons To Fight Boko Haram

0 Comments

9 Hours Ago

In a statement on Tuesday, Acting Director Army Public Relations, Col. Sagir Musa, said, “The major highlight of the posting includes the posting and appointment of Maj Gen ACC Agundu from Special Task Force, Operation SAFE HAVEN, Jos, to Nigerian Army Resource Centre (NARC), Abuja, as Senior Research Fellow, Major General HI Bature from Defence Headquarters (DHQ), Defence Liaison Office, National Assembly Abuja, to Army Headquarters, Department of Civil Military Affairs and appointed Chief of Civil-Military Affairs, Maj Gen UM Mohammed from Nigerian Army Property Limited (NAPL) to the Office of the Chief of Army Staff and appointed Special Adviser Nigerian Army University Biu/Deputy Chairman Board of Trustees NAPL, while the erstwhile Special Adviser Nigerian Army University Biu Maj Gen CC Okonkwo now redeployed to STF Operation SAFE HAVEN Jos and appointed Commander, Maj Gen F Yahaya from Headquarters 1 Division Kaduna to Headquarters.

“Theatre Command Operation LAFIYA DOLE (OPLD) Maiduguri and appointed Commander, while Maj Gen OG Adeniyi is redeployed from Headquarters Theatre Command OPLD Maiduguri to NARC as Senior Research Fellow, Maj Gen S Idris from Sector 2 OPLD Damaturu- Yobe State redeployed to DHQ Abuja and appointed Director Liaison.

FLASH: @HQNigerianArmy Removes General Adeniyi Who Disclosed Weakness of The Military Against Boko Haram In Leaked Video pic.twitter.com/7B2JZC5fwC

— Sahara Reporters (@SaharaReporters) March 31, 2020

“Others affected include – Maj General AA Adesope from Office of the Chief of Army Staff Directorate of Audit and Financial Management to NAPL and appointed Group Managing Director, Maj Gen MG Ali from Headquarters Theatre Command OPLD Maiduguri to Headquarters 4 Special Forces Command Doma, Nasarawa State as Commander while the erstwhile Chief of Civil-Military Affairs AHQ Abuja Maj Gen US Mohammed has been redeployed to 1 Division Kaduna and appointed General Officer Commanding.

“Similarly, Brig Gen HI Daniel from the Defunct Army Special Forces Command Maiduguri to Headquarters Training and Doctrine Command Minna and appointed Director Army Training Support, Brig Gen BE Onyeuko is to remain in DHQ Abuja as Acting Director Defence Media Operation, Brig Gen NM Jega from Training and Doctrine Command Minna to Infantry Corps Centre Jaji and appointed Chief of Staff, Brig Gen LA Araba from Nigerian Army Welfare Limited by Guaranty Abuja now redeployed to Sector 2 OPLD Damaturu, Yobe State as Ag Commander, Brig Gen VO Ita from DHQ, Abuja to Headquarters 402 Special Forces Brigade Azare and appointed Commander while Brig Gen JAL Jimoh from Sector 3 Artillery Brigade OPLD Monguno to Headquarters 31 Brigade Minna and appointed Commander and Brig Gen GTO Ajetunmobi has been redeployed from 31 Brigade Minna to Nigeria Army Welfare Limited by Guaranty, Abuja as Executive Director Operation.

See Also

Boko Haram

How Boko Haram Terrorists Dealt Us Heavy Blow –Nigerian Army Commander

0 Comments

1 Day Ago

“Others are – Brig Gen LG Lepdung from Headquarters Infantry Corps Centre Jaji to DHQ Abuja and appointed Deputy Director Procurement (Logistics), Brig Gen MO Ihanuwaze to remain in Office of the Chief of Army Staff Directorate of Audit and Financial Management as Acting Director, Brig Gen EC Obi – Osang from the defunct Headquarters 707 Special Forces’ Brigade Makurdi to Headquarters 401 Special Forces’ Brigade Makurdi as Commander while Brig Gen GM Mutkut is redeployed from the Defunct Nigerian Army Amphibious Command OPLD Baga to Headquarters 403 Amphibious Brigade Baga and appointed Commander and Brig Gen JR Lar from Nigerian Army School of Artillery Kachia to Sector 3 Artillery Brigade OPLD Monguno as Commander.

“Also, Colonel DJ Abdullahi from the defunct Headquarters Nigerian Army Special Forces’ Command Maiduguri to Headquarters 4 Special Forces’ Command Doma Nasarawa State and appointed Acting Chief of Staff, Colonel EC Emere from Nigerian Army Archives to Nigerian Military School Zaria as Deputy Commandant and Col MO Agi is to remain in Headquarters Nigerian Army Armour Corps Bauchi as Acting Chief of Staff among others.

“All the postings and appointments take effect from the 1st of April 2020.

“While wishing all the officers well in their respective appointments, the Chief of Army Staff enjoins them to take their new responsibilities/appointments seriously and discharge all duties professionally with utmost loyalty to the Nation and the Service.”

FLASH: @HQNigerianArmy Generals Admit Boko Haram Challenges in Unusual Video pic.twitter.com/D8RXxsTPQj

— Sahara Reporters (@SaharaReporters) March 29, 2020

Military

News

AddThis

:

Original Author

:

SaharaReporters, New York

Disable advertisements

:

Read More
http://saharareporters.com/2020/03/31/nigerian-army-redeploys-senior-officers-major-shake

Views: 0

April 1, 2020
CIMB closes Menara UAB branch for Covid-19 sanitisation

KUALA LUMPUR: The CIMB branch at Menara UAB on Jalan Tun Perak here has been closed to undergo thorough sanitisation and deep cleaning after one of its employees tested positive for Covid-19.

In a statement, CIMB Group Holdings Bhd said it has business continuity plans in place for both head office and branches to ensure continuity of essential services.

“The group had earlier implemented several precautionary measures to ensure the well-being of customers and staff, which include a mandatory travel declaration policy, hygiene and social distancing measures at both head office and branches,” it said.

The banking group said affected staff are currently being treated at a government hospital and contact tracing is being conducted.

All those in direct contact with the affected employee will be placed under home quarantine until given the appropriate medical clearance, it added. – Bernama

Read More
https://www.thesundaily.my/local/cimb-closes-menara-uab-branch-for-covid-19-sanitisation-YA2200405

Views: 0

March 31, 2020
New WHO Guide to help countries expand access to essential medicines
WHO’s new user guide for countries, ‘Selection of medicines at country level’, is based on the WHO Model List of Essential Medicines. It sets out the key actions countries should undertake to develop and update their own
national essential medicines lists based on the treatment needs of their populations and their capacity to reimburse payments for medicines.

The document also aims to support countries in progressing towards universal health coverage. Today, approximately half of the world’s population is unable to access essential medicines. The large majority of these people live in poorer countries,
but rising prices of new medicines are also becoming a challenge for health systems in wealthy countries.

A careful selection of essential medicines is the first step in ensuring a population can obtain the quality-assured medicines it needs at an affordable price. Countries need to do more to ensure that all people and communities can access highly
effective medicines. WHO’s new manual is a resource to do just that.

The document, intended for policy makers in charge of national medicines and reimbursement lists, aims to increase transparency on how essential medicines are selected. Most national lists of essential medicines have several differences when compared
with WHO’s model list, which lists only medicines of proven safety and efficacy. Some national lists include medicines that bring little extra benefit to patients. Decision-makers should refer to the WHO global list to gauge the public health
value of listing certain medicines for their populations.

The essential medicines concept

Essential medicines are:
- those that satisfy the priority health care needs of the population
- selected with due regard to disease prevalence and public health relevance, evidence of efficacy and safety, and comparative cost-effectiveness
- intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality and adequate information, and at a price the individual and community can afford.
The essential medicines concept is global and forward-looking. It incorporates the need to regularly update medicines selections to reflect new therapeutic options and changing therapeutic needs; the need to ensure drug quality; and the need for continued
development of better medicines, medicines for emerging diseases and medicines to meet changing resistance patterns.

Achieving universal health coverage and equity in public health depends on access to essential, high-quality and affordable health related technologies for all. To achieve access for all by 2030, at least two billion more people will need to have access
to essential health services by 2030.

In an effort to make the Model List of Essential Medicines more readily accessible, WHO recently developed an electronic version of the list, bringing the traditional EML to computer screens, tablets and smartphones in a freely accessible, downloadable,
online database.

Link to manual: Selection of essential medicines at country level

Link to e-EML: Model List of Essential Medicines

Read More
https://www.who.int/news-room/detail/30-03-2020-new-who-guide-to-help-countries-expand-access-to-essential-medicines

Views: 0
March 31, 2020
WHO releases guidelines to help countries maintain essential health services during the COVID-19 pandemic

The COVID-19 pandemic is straining health systems worldwide. The rapidly increasing demand on health facilities and health care workers threatens to leave some health systems overstretched and unable to operate effectively.

Previous outbreaks have demonstrated that when health systems are overwhelmed, mortality from vaccine-preventable and other treatable conditions can also increase dramatically. During the 2014-2015 Ebola outbreak, the increased number of deaths caused
by measles, malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola
^[1,2].

“The best defense against any outbreak is a
strong health system,” stressed WHO Director-General Tedros Adhanom Ghebreyesus.
“COVID-19 is revealing how fragile many of the world’s health systems and
services are, forcing countries to make difficult choices on how to best meet
the needs of their people.”

To help countries navigate through these challenges, the World Health Organization (WHO) has updated operational planning guidelines in balancing the demands of responding directly to COVID-19 while maintaining essential health service delivery, and mitigating
the risk of system collapse. This includes a set of targeted immediate actions that countries should consider at national, regional, and local level to reorganize and maintain access to high-quality essential health services for all.

Countries should identify essential services that will be prioritized in their efforts to maintain continuity of service delivery and make strategic shifts to ensure that increasingly limited resources provide maximum benefit for the population. They
also need to comply with the highest standard in precautions, especially in hygiene practices, and the provision of adequate supplies including personal protective equipment This requires robust planning and coordinated actions between governments
and health facilities and their managers.

Some examples of essential services include: routine vaccination; reproductive health services including care during pregnancy and childbirth; care of young infants and older adults; management of mental health conditions as well as noncommunicable diseases
and infectious diseases like HIV, malaria and TB; critical inpatient therapies; management of emergency health conditions; auxiliary services like basic diagnostic imaging, laboratory services, and blood bank services, among others.

Well-organized and prepared health systems can continue to provide equitable access to essential service delivery throughout an emergency, limiting direct mortality and avoiding increased indirect mortality.

The guidelines stress the importance of keeping up-to-date information. This requires frequent transparent communications with the public, and strong community engagements so the public can maintain trust in the system to safely meet their
essential needs and to control infection risk in health facilities. This will help ensure that people continue to seek care when appropriate, and adhere to public health advice.

1. Elston, J. W. T., Cartwright, C., Ndumbi, P., & Wright, J. (2017). The health impact of the 2014–15 Ebola outbreak. Public Health, 143, 60-70.

2. Parpia, A. S., Ndeffo-Mbah, M. L., Wenzel, N. S., & Galvani, A. P. (2016). Effects of response to 2014–2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Emerging infectious diseases, 22(3), 433.

For interviews please contact: Tarik Jasarevic

To access the full guidance please visit: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/maintaining-essential-health-services-and-systems

For further information and guidance on COVID-19 please visit: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Read More
https://www.who.int/news-room/detail/30-03-2020-who-releases-guidelines-to-help-countries-maintain-essential-health-services-during-the-covid-19-pandemic

Views: 0

March 31, 2020
World TB Day 2020 Newsletter

Latest news and updates from WHO

Dear colleagues and friends,

World TB Day, this year, comes at a sobering time – as the world grapples with the COVID-19 pandemic. We stand in solidarity with those affected, those at the frontlines of the fight to combat COVID-19, as well as those who continue efforts to support
those ill with longstanding health problems like TB, HIV and other diseases. However, we cannot forget the millions and their families who battle TB every day and lose their lives to this ancient disease – which remains the world’s top
infectious killer.

As eloquently emphasized by WHO Director-General Dr Tedros Adhanom Ghebreyesus in his press briefing on COVID-19 yesterday, “I’d like to remind everyone that although COVID-19 is dominating the world’s attention-there is another respiratory
disease that is both preventable and treatable, but kills 1.5 million people every year – that disease is tuberculosis”

“It’s Time”, the focus for World TB Day this year is therefore on urgently accelerating the TB response to save lives and end suffering, even in times of crisis. This will be essential if we are to reach the targets and commitments made
by Heads of State at the 2018 UN High Level Meeting on TB.

We have made important strides against the TB epidemic to date.

We announced last year, that more people received life-saving treatment for tuberculosis in 2018 than ever before, largely due to improved detection and diagnosis. Globally, 7 million people were diagnosed and treated for TB – up from 6.4 million in 2017
– enabling the world to meet one of the milestones towards the United Nations political declaration targets on TB and the WHO Director-General Flagship Initiative Find.Treat.All End TB jointly with Stop TB Partnership and the Global Fund. This
has been a big win for the TB community.

WHO is working with countries to roll out important guidelines, including a comprehensive package on TB preventive treatment released today, and updated MDR TB guidelines to promote the use of all-oral regimens for patients with drug-resistant TB which
would be helpful – particularly at this point, when visiting health centers is a challenge. Furthermore, WHO has developed a note to guide and urge countries to ensure continuity of TB services during the COVID-19 pandemic.

We are strengthening our collaboration with civil society – more information is highlighted in the WHO Civil Society Taskforce Progress Review released today.

Youth mobilization is being ramped up through the WHO 1+1 Youth Initiative to end TB and the Global Youth Declaration to End TB. Multisectoral accountability is being promoted in countries through our framework and we have finalized a new global strategy
on TB research and innovation, that will be reviewed by the World Health Assembly.

Yet, the gains we have made are at risk – if there is any slackening of commitment and action, especially in times of crisis.

We are at a crossroads and we need to unite forces to take the path of success that will save lives and end suffering.

I was especially heartened today, to see the TB community coming together like never before. We all took our events to the virtual realm due to COVID-19 lockdowns. The WHO Online Talk Show held this afternoon, had a powerful line up of speakers that included,
TB survivors and advocates, civil society, high level government representatives, heads of agencies, researchers and partners. As of this evening we have surpassed 10,000 views on YouTube. I also participated in townhalls organized by Stop TB Partnership.
Our joint efforts have indeed ensured a continuing spotlight on those affected by TB, and clearly shows that no matter what the barrier, we can surpass it if we work together.

I am proud to stand shoulder-to-shoulder with you all virtually – and recommit to champion End TB efforts till we reach the finish line.

It’s time to deliver on our promises and ensure no one is left behind.

It’s time to End TB!

Dr Tereza Kasaeva
Director
Global TB Programme
World Health Organization

World TB Day Talk Show

In the backdrop of the global battle against COVID-19, WHO organized a special online talk show to mark World TB Day 2020. The talk show had a powerful line up of speakers from among TB survivors and advocates, civil society, high-level government representatives,
heads of agencies, researchers and partners. The video was streamed live on WHO’s Youtube channel crossing over 10,000 views in a few hours. Watch the talk show video

Spotlight on TB Preventive Treatment

New WHO recommendations to prevent tuberculosis aim to save millions of lives

24 March 2020 News release

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. Read more

The full package is available below and at our World TB Day Campaign Page

WHO Civil Society Taskforce on TB: Progress Review

The WHO Civil Society Taskforce provides a platform for meaningful engagement of civil society, building on the commitment of the Director-General, with emphasis on harnessing the untapped potential in engagement with civil society and affected communities
al all levels. To mark World TB Day 2020, the Task Force has released a Progress Review highlighting key achievements since its formation in 2018.

Access link here

WHO eTB guidelines: A digital platform to promote adolopment of TB recommendations

WHO Global TB Programme / McMaster University

The WHO Global Tuberculosis (TB) Programme, in collaboration with McMaster University, Canada, is developing a smart platform to improve access to and use of all WHO recommendations on TB prevention and care. The WHO eTB guidelines platform will facilitate
the adoption, adaptation and implementation (“adolopment”) by countries of recommendations across the continuum of care. This digital platform will provide a variety of users – TB programme managers, healthcare workers including
nurses, researchers, patients and affected communities – with easy access to all essential information about WHO-s current policy guidance on TB.

The first set of recommendations on TB preventive treatment were released on this new platform on World TB Day.

WHO eTB guidelines platform

Infographic

TB and COVID-19

24 March 2020 News release

Geneva – As the world comes together to tackle the COVID-19 pandemic, it is important to ensure that essential health services and operations are continued to protect the lives of people with TB and other diseases or health conditions. Health services,
including national programmes to combat TB, need to be actively engaged in ensuring an effective and rapid response to COVID-19 while ensuring that TB services are maintained. Read more

Let’s never forget: It’s time to end TB

Ksenia Schenina

Ksenia Schenina

24 March 2020 Photo story

On World TB Day 2020, the theme – “Its time” – stresses the urgency to end the TB epidemic. TB survivor and advocate, Ksenia Schenina, talks about her struggle with the disease, the persistence of stigma and the role that remembrance can play
in fighting it. Through her TB memorial project, she aims to remember those who passed away from this terrible and ancient disease. “We do it to show what kind of people they were – what kind of things they liked, what kind of music
they listened to and what their favorite movies were; if they liked fishing or dreamt of a flight to space,” she says. Read more

Commentary

To end TB, we must invest in research and innovation

24 March 2020 Commentary

If the world is to get anywhere near ending TB, a disease that killed more than 1.5 million people in 2018, something significant needs to change.

TB remains the world’s leading infectious killer and yet, in the last 50 years, only three new drugs and regimes have been developed to combat the disease. “What we need is more research and more tools in the pipeline; better diagnostics,
more effective vaccines, and safer, shorter drug regimes,” explains Dr Tereza Kasaeva, Director of the World Health Organization Global Tuberculosis Programme. Read more

Emily: A Day in the Life of a TB Nurse

Maria Emily C. Ballesteros

Watch this story of Emily, a nurse managing the tuberculosis (TB) program of the City Health Office in Tuguegarao City. Her dream for Tuguegarao is to one day see zero TB cases and that no one dies from this infectious disease. Nurses and healthcare workers
play a critical role in TB prevention and care. It’s time to invest in them to improve healthcare for all. We thank all the nurses, midwives and healthcare workers working to #EndTB! Watch the video

Updates and messages

New research tool supports scale-up of digital technologies to End TB

24 March 2020 TDR news item

National anti-tuberculosis efforts are increasingly involving digital technologies, such as mobile applications to support treatment adherence and electronic surveillance systems that enable real-time monitoring of a country’s TB situation. Read more

World TB Day 2020: It’s Time for solidarity

24 March 2020 HIV/TB news item

At this unique time in history when the world is grappling with the COVID-19 pandemic, the WHO Department of Global HIV, Hepatitis and STI Programmes stands in solidarity with governments and communities as they seek to maintain health services
and continue to address the needs of patients suffering from HIV and tuberculosis (TB). Read more

New, shorter treatment to prevent TB to be rolled out in five high TB burden countries

24 March 2020 news item

Three-month regimen expected to prevent TB in those at highest risk of developing the disease, including people living with HIV and children under the age of five
Today, the Aurum Institute and its partners, as part of the IMPAACT4TB project, announced that five high-burden TB countries will roll out a new, shorter drug regimen (known as 3HP) to prevent TB. The announcement comes as countries around the world mark World TB Day, which takes place every year on March 24th. Countries that will initially provide the new regimen with funding from Unitaid, U.S. PEPFAR and the Global Fund include Cambodia, Ethiopia, Kenya, Malawi, South Africa and Zimbabwe. More than 120,000 patient courses of 3HP will be delivered by the project to 12 countries in 2020. An additional 1 million patient courses are expected to reach low- and middle-income countries by the end of the year, through the combined support of Unitaid, Global Fund, the Stop TB Partnership’s Global Drug Facility (GDF) and PEPFAR. Read more

Read More
https://www.who.int/news-room/detail/30-03-2020-world-tb-day-2020-newsletter

Views: 0

March 31, 2020
Muhyiddin visits MAEPS low-risk patient Quarantine & Treatment Centre

SERDANG: Prime Minister Tan Sri Muhyiddin Yassin today visited the Quarantine and Treatment Centre for low-risk Covid-19 patients at the Malaysia Agro Exposition Park Serdang (MAEPS) here.

The prime minister was accompanied by Health Minister Datuk Seri Dr Adham Baba, Ministry of Health (MOH) secretary-general Datuk Seri Dr Chen Chaw Min and Health director-general Datuk Dr Noor Hisham Abdullah.

Muhyiddin, who arrived at the centre at 5.45pm, spent almost an hour being briefed and touring the centre, which was successfully prepared for operations by various government agencies, under the coordination of the National Disaster Management Agency (Nadma), within three days.

Met after the visit, Dr Adham told reporters that the centre was the brainchild of the prime minister himself to prepare for any possibility of a drastic surge in the number of Covid-19 infections.

“We will treat Covid-19 positive patients who are asymptomatic or have mild symptoms here,” he said.

The centre has the capacity to place up to 600 patients at any one time and it will be coordinated by Nadma with the cooperation of the MOH, the Armed Forces, the Fire and Rescue Department, the Civil Defence Force, the Social Welfare Department and the Public Works Department.

Among others, it will provide clinical services, Covid-19 wards, resuscitation areas to stabilise patients during emergencies, as well as ambulance, pharmacy and pathology laboratory services.

Facilities for patients include beds, tables and chairs, lockers, television, lounges, Wifi access, computers, surau, closed-circuit television (CCTV), toilets and baths, changing rooms and rest areas.

For those on duty, there are nurse stations, treatment/resuscitation room, rest areas, changing rooms and baths, including for the ‘donning and doffing’ of personal protective equipment (PPE) as well as meeting and seminar rooms. – Bernama

Read More
https://www.thesundaily.my/local/muhyiddin-visits-maeps-low-risk-patient-quarantine-treatment-centre-AN2197222

Views: 0

March 30, 2020
RM200 monthly assistance for firefighters during MCO: Zuraida

KUALA LUMPUR: Housing and Local Government Minister Zuraida Kamaruddin (pix) today announced that Malaysian Fire and Rescue Department (JBPM) personnel will receive RM200 per month throughout the implementation of the Movement Control Order (MCO).

She said the incentive was an appreciation of their roles and services as front liners as the country sought to combat the spread of the Covid-19 outbreak.

“In recognition of the roles of JBPM personnel as front liners, the government through the ministry will provide RM200 per month throughout the MCO period,” she said in a public service announcement which was broadcast on all television stations today.

She said the incentive was part of her ministry’s initiatives implemented under the RM250 billion people-centric economic stimulus package (Prihatin) announced by Prime Minister Tan Sri Muhyiddin Yassin on Friday.

The Prihatin package covers all walks of life and also focuses on the B40 group, including those living in low-cost flats across the country, small traders and factory workers.

Zuraida said several other initiatives implemented by her ministry under the Prihatin package include the six months rental payment exemption for the People’s Housing Projects (PPRs) under the ministry’s management, involving 3,636 units of housing and costing the government RM3 million.

“There is also a six-month deferment of monthly repayment from April to September for the Rent to Own (RTO) of PPR units under the ministry’s management involving a total of RM5.7 million and 4,649 units of houses,” she said.

Zuraida, who is also Ampang MP, said to ease the burden of borrowers, all pawn brokers registered under the ministry were directed to extend the redemption period without charging interest during the MCO period. – Bernama

Read More
https://www.thesundaily.my/local/rm200-monthly-assistance-for-firefighters-during-mco-zuraida-NJ2193528

Views: 0

March 29, 2020
Schistosomiasis elimination: refocusing on snail control to sustain progress
Substantial progress has been made during the past decade to prevent and control schistosomiasis (also known as bilharziasis) globally. The disease affects more than 230 million people, mostly in sub-Saharan Africa.

Progress is mainly due to large-scale periodic treatment of affected populations with praziquantel, the only medicine recommended by the World Health Organization (WHO) against all forms of schistosomiasis. Regular treatment cures mild symptoms and prevents
progression to severe, chronic disease.

“Through progressive scale-up of periodic large-scale treatment
to control morbidity in many endemic countries, we are closer to
achieving the minimum target of 75% global coverage of all school‐aged
children,” said Dr Amadou Garba Djirmay, who leads WHO’s global schistosomiasis control programme. “But
if we want to achieve elimination, we must go a step further to
introduce snail control in hot spots and in areas targeting elimination.
This is bound to increase impact and accelerate progress towards
interruption of transmission.”

Expansion of treatment is largely supported by donated praziquantel from Merck KGaA of up to 250 million tablets annually. In 2018, almost 78 million children were treated, representing 63% of all school‐aged children eligible for treatment.

Transmission: role of snails

Schistosomiasis is an acute, chronic parasitic disease caused by infection with trematode worms of the genus Schistosoma. It is prevalent in tropical and subtropical areas, especially in poor, rural communities that have little or no access to
safe drinking‐water and basic sanitation. Infection is transmitted when people suffering from schistosomiasis contaminate freshwater sources when evacuating urine and faeces containing the parasite’s eggs.

Once an egg comes into contact with fresh water, it releases miracidia (hatchlings) which enter a snail and produce hundreds of cercariae (larvae) daily. The cercariae enter the human body on contact with the skin and develop into adult worms.

Besides treatment with praziquantel, eliminating snail hosts and improving sanitation are important methods for sustainable prevention of the disease. Dam and irrigation projects are known to be potential sites for outbreaks of the disease. Snail management,
often achieved through mollusciciding, can help to reduce transmission by eliminating these intermediate snail hosts.

Vector control

In 2017, the World Health Assembly – WHO’s decision making body – adopted resolution WHA70.16 on the Global Vector Control
Response, calling on Member States to develop or adapt national vector control strategies and operational plans. The strategy aims to reduce by at least 40% the incidence of vector borne diseases, including schistosomiasis, by 2025.

In response, WHO is reinforcing snail control as part of its strategic approach to achieve the target of eliminating schistosomiasis as a public health problem and, ultimately, the goal of elimination of transmission. Snail control will complement mass
treatment campaigns and sustain the public health impact of this core intervention.

To facilitate implementation of snail control, in 2019 WHO published on specific, standardized procedures and criteria for efficacy
testing and evaluation and in 2017 a manual on the use of molluscicides in the field. WHO is also planning to strengthen capacities
of health staff in medical malacology in order to reinforce snail control activities in countries.

In the past, molluscicides (particularly niclosamide¹ based products) were widely used in schistosomiasis control programmes. For example, in China programmes largely relied on snail control for over 30 years to overcome the disease as a public
health problem. In other parts of the world, however, snail control programmes were gradually discontinued and competencies faded away.

“Snail control is a crucial component of the global schistosomiasis elimination strategy,” said Dr Rajpal Yadav, Scientist, WHO Department of Control of Neglected Tropical Diseases. “It
is time we look for new snail control products that are cost–effective
and of low risk to humans and the environment. Some efforts are being
made to explore molluscicide compounds from plants, marine algae and
microorganisms.”

An integrated control strategy involving mass treatment with praziquantel, snail control and environmental modification, wider access to sanitation and safe water, economic and environmental development, health education and poverty-alleviation can greatly
contribute to sustainable control and elimination of schistosomiasis.

WHO’s new road map on neglected tropical diseases for 2021–2030, due to be launched later this year, advocates enhanced financial and political support to achieve the target of interruption of transmission. Additional research to address gaps,
develop tools and optimize the impact of existing programmes with snail control will complement the core strategic approach.

Schistosomiasis: forms of the disease

There are two major forms of schistosomiasis – intestinal and urogenital.

Intestinal schistosomiasis usually results in diarrhoea and blood in the stool; enlargement of the liver and of the spleen and portal hypertension are common in advanced cases.

Urogenital schistosomiasis is characterized by the presence of blood in the urine. Chronic infection results in fibrosis of the bladder and ureter that can evolve to hydronephrosis and create conditions for bladder cancer.

In women, urogenital schistosomiasis can cause vaginal bleeding, pain during sexual intercourse and nodules in the vulva, a condition now described as female genital schistosomiasis. In men, urogenital schistosomiasis can induce disease in the seminal
vesicles and prostate.

¹Limitations with the use of formulations based on niclosamide include restrictions on the usage of water immediately after application and temporary toxicity to non-target aquatic organisms including
fish, amphibians and invertebrates.
Read More
https://www.who.int/news-room/detail/25-03-2020-schistosomiasis-elimination-refocusing-on-snail-control-to-sustain-progress

Views: 0
March 27, 2020