Global risk management experts are calling for fire education initiatives to be included in driver safety programs so that drivers are better prepared for an emergency if faced with it on the roads.
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Tag: Management
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WHO steps up action to improve access to safe blood
The World Health Organization’s new action plan to speed up universal access to safe blood and blood products pulls together existing recommendations and recommends new improved ways of working. It’s the start of a four-year collaborative effort to improve blood transfusion and blood-based therapies in all countries.
Safe blood saves lives in all sorts of circumstances, not least in emergency and epidemic settings. Blood transfusion and blood products are critical for birth delivery for both the mother and baby; the survival and quality of life of patients suffering from life-threatening conditions such as haemophilia, thalassemia, immune deficiency and cancer; treating severe injuries and carrying out medical and surgical procedures.
But progress in blood safety and availability has been slow in many parts of the world, placing patients’ safety at risk and putting undue pressure on health workers. Progress is also mostly restricted to developed countries. Out of the approximate 118 million blood donations collected globally, 42% are collected in high-income countries, home to 16 % of the world’s population. And one out of four low-income countries do not test all donated blood, while 54% of countries do not have surveillance systems to securitise the supply chain from blood donor to patient.
Challenges include: slow implementation of national blood policies and weak blood regulatory systems; insufficient number of voluntary blood donors (who are considered the safest donors); poor quality management of screening tests, blood grouping and compatibility testing; inappropriate clinical use of blood; insufficient national funding for blood safety.
To address these, WHO has set out six key objectives for all countries and in particular those with weak blood systems:
- appropriately structured, well-coordinated and sustainably resourced national blood systems;
- regulatory capacity to ensure the quality and safety of blood;
- functioning and efficiently managed blood services;
- effective implementation of patient blood management to optimize transfusion practices;
- effective surveillance, haemovigilance and pharmacovigilance, supported by comprehensive and accurate data collection systems;
- partnerships, collaboration and information exchange to achieve key priorities and jointly address challenges and emerging threats at global, regional and national levels.
The Organization looks forward to working with partners worldwide to implement the plan, improve blood supply particularly in the low and middle-income countries where this is so urgently needed, and save lives. The plan will run from 2020-2024.
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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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WHO Action framework to advance universal access to safe, effective and quality assured blood products 2020 -2023
In response to calls for action, WHO has provided guidelines, physical standards, training and technical support to improve blood product quality, safety and availability in WHO regions and in countries. Despite these actions, progress in blood availability and safety under effective regulation has been slow in many parts of the world.
For that reason, the WHO Action framework for blood products 2020-2023, proposes a renewed effort to scale up programme implementation to improve global adequacy of blood donation, and universal access to quality and safe blood and blood components for transfusion, and plasma derived medicinal products.
The Action Framework provides strategic direction to WHO’s work for the years 2020-2023. It identifies six strategic objectives: appropriately structured, well-coordinated and sustainably resourced national blood systems; regulatory capacity to ensure the quality and safety of blood; functioning and efficiently managed blood services; effective implementation of patient blood management to optimize transfusion practices, effective surveillance, haemovigilance and pharmacovigilance, supported by comprehensive and accurate data collection systems; and partnerships, collaboration and information exchange to achieve key priorities and jointly address challenges and emerging threats at global, regional and national levels.
The Action Framework will improve coordination and collaboration at all levels of WHO. The document will promote and strengthen new and existing partnerships, as areas for collaborative action are clearly identified. Moreover, it demonstrates the need for support to WHO (including sustainable funding) to coordinate the implementation of this ambitious plan. As a result, the Action Framework for blood products will allow WHO to more effectively carry out its mandate on blood, and to increase the impact of WHO activities to strengthen blood systems and blood regulation in countries and regions and eventually to ensure universal access to blood products worldwide.
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Statement on the meeting of the International Health Regulations (2005) Emergency Committee for Ebola virus disease in the Democratic Republic of the Congo on 12 February 2020
The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) to review the current Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo (DRC) took place on Wednesday, 12 February 2020, from 14:00 to 16:45 Geneva time (CEST).
Proceedings of the meeting
Members and advisors of the Emergency Committee were convened by teleconference.
The Secretariat welcomed the Committee and thanked them for their support. The meeting was turned over to the Chair, Dr Robert Steffen.
Dr Steffen also welcomed the Committee and gave the floor back to the Secretariat.
Representatives of WHO’s legal department and the department of compliance, risk management, and ethics briefed the Committee members on their roles and responsibilities.
Committee members were reminded of their duty of confidentiality and their responsibility to disclose personal, financial, or professional connections that might be seen to constitute a conflict of interest. Each member who was present was surveyed and no conflicts of interest were judged to be relevant to the meeting.
The Chair then reviewed the agenda for the meeting and introduced the presenters.
Presentations were made by representatives of the Ministry of Health of the Democratic Republic of the Congo (DRC), the WHO Secretariat, and the UN Ebola Emergency Response Coordinator.
The current situation in the DRC was reviewed. As of 10 February 2020, there were a total of 3431 cases, of which 3308 were confirmed and 123 were probable. 2253 persons have died (66%). Between 3 and 9 February 2020, three new confirmed cases were reported in Beni Health Zone, North Kivu. These three cases were already registered as contacts and two were under surveillance at the time of detection. More than 2000 contacts are being followed. There has been an increase in the number of security incidents in recent months.
Challenges that remain include: strengthening of community acceptance for full commitment to response measures; protection of personnel at strategic health checkpoints; improvement of infection prevention and control practices in health facilities; strengthening of the local health system; and comprehensive treatment and support for patients in recovery.
The WHO Secretariat gave an overview of the epidemiological situation, which shows an overall encouraging trend in case incidence and geographic spread. It was noted that sustaining this progress depends on the security situation and control of the well-known drivers of transmission, particularly in traditional health facilities, and on continued trust and communication with the community.
A risk communication and community engagement programme has been developed, as has an EVD survivors programme. It is critical to ensure the long-term sustainability of these two initiatives.
The situation in countries neighbouring DRC was reviewed, as was preparedness in nonaffected areas of DRC. An EVD operational readiness standardized approach has been implemented in 9 priority countries. More than 2400 alerts have been investigated, and more than 14,600 health workers have been vaccinated.
The UN Ebola Emergency Response Coordinator gave a brief report on operational support, focused on security challenges and preparations for any resurgence of disease.
Context and Discussion
The Committee noted a great deal of progress in the situation since its last meeting and commended the response, under the leadership of the DRC Ministry of Health and the multisectoral coordination commission established in July 2019. Support provided by WHO, UN agencies, nongovernmental organizations and other partners has also contributed to limiting the spread and impact of this virus in a difficult context. An increase in the number of alerts was attributed to strong and proactive community surveillance.
Conclusions and Advice
It was the unanimous view of the Committee that this event still constitutes a public health emergency of international concern (PHEIC) under the IHR (2005).
The Committee acknowledged the revised risk assessment, which puts the risk now as high at national and regional levels, and low at the global level.
The Committee was concerned that withdrawing the PHEIC now might have adverse consequences for the response efforts through diminishing focus. Additionally, although the primary concern of the Committee is EVD, there are serious ongoing outbreaks of other diseases, including measles and cholera, in DRC. The country continues to need support to combat infectious diseases as well as to strengthen its health system. Further, there remains an urgent need to maintain international solidarity for the response.
The Committee noted the ongoing discussions about the interpretation in the text of the IHR (2005) of the terms international and regional spread, and about creating an intermediate level of response between the binary possibilities of PHEIC or no PHEIC, in a way that does not require reopening negotiations on the Regulations. The Committee supports these discussions, as an intermediate level would be as useful for gradually ending a PHEIC and for signaling the potential for one to be declared.
The Committee provided the following advice to the Director-General for his issuance as revised Temporary Recommendations under the IHR (2005).
For DRC:
- Sustain the political commitment and multisectoral coordination approach to the response.
- Continue to engage and build trust with associations of survivors to facilitate rapid detection of any cases arising from exposure to infected bodily fluids of survivors.
- Continue to strengthen capacity, implementation, and coordination for community awareness and engagement, including a focus on hotspots, preventing resurgence where cases have declined, and to support survivors in their communities.
- Further enhance the acceptance of response measures and address access and security issues by engaging influencers and decision makers for all interventions.
- Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision, including in private-sector and traditional health facilities.
- Continue cross-border screening and step up monitoring at checkpoints around hotspots and at main roads.
- Continue to implement and share real-time full-genome genetic sequencing of all new confirmed cases.
- Strengthen measures to prevent and manage nosocomial infections, including systematic mapping of health facilities, targeting of IPC interventions and sustain support to those facilities through monitoring and supervision.
- Strengthen preparedness in non-affected provinces of DRC, and more generally strengthen the health system across the country to respond to concurrent health emergencies.
- Continue to implement optimal vaccine strategies that have proven maximum impact on curtailing the outbreak, as recommended by WHO’s Strategic Advisory Group of Experts (SAGE).
For countries at risk:
- At-risk countries should maintain their work with partners to improve their preparedness for detecting and managing imported or locally acquired cases, including the transparent sharing of detailed information on suspect cases, as required by the International Health Regulations (2005), and sharing laboratory samples of suspect cases for confirmatory testing in accordance with WHO norms and guidance.
- Countries should continue to map population movements and sociological patterns that can predict risk of disease spread.
- Risk communications and community engagement, especially at points of entry, should be maintained.
For all countries:
- As recommended previously, no country should close its borders or place any restrictions on travel and trade.
- The Committee does not consider entry screening at airports or other ports of entry outside the region to be necessary.
The Committee emphasized the importance of continued support by WHO and other national and international partners towards the effective implementation and monitoring of these recommendations.
Based on this advice, the reports made by the affected State Party, and the currently available information, the Director-General accepted the Committee’s assessment and on 12 February 2020 maintained the Ebola outbreak in the Democratic Republic of the Congo as a Public Health Emergency of International Concern (PHEIC).
The Director-General endorsed the Committee’s advice and issued them as Temporary Recommendations under IHR (2005) to reduce the international spread of Ebola, effective 12 February 2020. The Director-General thanked the Committee Members and Advisors for their advice and requested their reassessment of this situation within two months or earlier if the situation requires.
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World experts and funders set priorities for COVID-19 research
Leading health experts from around the world have been meeting at the World Health Organization’s Geneva headquarters to assess the current level of knowledge about the new COVID-19 disease, identify gaps and work together to accelerate and fund priority research needed to help stop this outbreak and prepare for any future outbreaks.
The 2-day forum was convened in line with the WHO R&D Blueprint – a strategy for developing drugs and vaccines before epidemics, and accelerating research and development while they are occurring.
“This outbreak is a test of solidarity — political, financial and scientific. We need to come together to fight a common enemy that does not respect borders, ensure that we have the resources necessary to bring this outbreak to an end and bring our best science to the forefront to find shared answers to shared problems. Research is an integral part of the outbreak response,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “I appreciate the positive response of the research community to join us at short notice and come up with concrete plans and commitment to work together.”
The meeting, hosted in collaboration with GloPID-R (the Global Research Collaboration for Infectious Disease Preparedness) brought together major research funders and over 300 scientists and researchers from a large variety of disciplines. They discussed all aspects of the outbreak and ways to control it including:
- the natural history of the virus, its transmission and diagnosis;
- animal and environmental research on the origin of the virus, including management measures at the human-animal interface;
- epidemiological studies;
- clinical characterization and management of disease caused by the virus;
- infection prevention and control, including best ways to protect health care workers;
- research and development for candidate therapeutics and vaccines;
- ethical considerations for research;
- and integration of social sciences into the outbreak response.
“This meeting allowed us to identify the urgent priorities for research. As a group of funders we will continue to mobilize, coordinate and align our funding to enable the research needed to tackle this crisis and stop the outbreak, in partnership with WHO,” said Professor Yazdan Yazdanpanah, chair of GloPID-R. “Equitable access – making sure we share data and reach those most in need, in particular those in lower and middle-income countries, is fundamental to this work which must be guided by ethical considerations at all times.”
During the meeting, the more than 300 scientists and researchers participating both in person and virtually agreed on a set of global research priorities. They also outlined mechanisms for continuing scientific interactions and collaborations beyond the meeting which will be coordinated and facilitated by WHO. They worked with research funders to determine how necessary resources can be mobilized so that critical research can start immediately.
The deliberations will form the basis of a research and innovation roadmap charting all the research needed and this will be used by researchers and funders to accelerate the research response.
Note to editors
GloPID-R is a global alliance of international research funding organizations investing in preparedness and response to epidemics.
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Ministers to agree new global road safety agenda to 2030
Government ministers and senior officials from over 100 countries will meet in Stockholm, Sweden from 19-20 February to discuss new steps to halve road traffic deaths and injuries by 2030, in line with global targets agreed in the United Nations Sustainable Development Goals (SDGs).
“The fact that an estimated 1.35 million lives are lost every year due to road traffic collisions is an outrage. It is an unacceptable price to pay for mobility,” said Dr Tedros Adhanom Ghebreyesus, Director-General at the World Health Organization (WHO).
Road traffic injuries are now the leading cause of death for children and young adults aged 5 to 29 years, according to WHO’s most recent Global status report on road safety.
More than half of all road traffic deaths occur among pedestrians, cyclists and motorcyclists. The risk of a road traffic death remains three times higher in low-income countries than in high-income countries. Moreover, as many as 50 million people experience non-fatal road injuries, which impose human suffering and major economic losses.
“Most road traffic deaths and injuries can be prevented, using tried and tested strategies,” added Dr Tedros. “This conference is an opportunity for the world to embrace a new agenda to radically reduce the number of lives lost on our roads and re-think how we can provide access to safe, affordable, accessible and sustainable transport systems for all.”
Progress in road safety
Many countries have already made progress through effective road safety management and focusing on better legislation and enforcement around key risks such as speeding; drinking and driving, and failing to use seatbelts. They have also improved infrastructure through measures such as safer sidewalks and dedicated lanes for cyclists; implemented vehicle standards such as those that mandate advanced braking and electronic stability control; and enhanced post-crash care.
Improvements have occurred when a number of sectors have been involved – including transport, health, urban planning and law enforcement, among others. Success has also depended mainly on strong leadership and political will at the highest level of government and in close collaboration with civil society and the private sector.
The Stockholm Declaration
Hosted by the Government of Sweden in collaboration with WHO, the 3rd Global Ministerial Conference on Road Safety offers delegates an opportunity to share successes and lessons learned, chart future strategic directions for global road safety, and define ways to fast-track progress around proven strategies to save lives.
The Stockholm Declaration will be presented as the final outcome document of the Ministerial Conference calling for strong political will and international cooperation as well as partnerships across many sectors of society. The Declaration will lay out key recommendations for accelerated action to drive progress towards halving global road traffic deaths and injuries by 2030.
Beyond preventing human suffering and major economic losses, addressing road traffic deaths and injuries has positive impact across all aspects of society and development ─ including those linked to environment, climate change, education, employment, energy, poverty, human rights and equality ─ as outlined in the SDG targets.
Note to editors:
Road safety is reflected in the SDGs agreed in 2015, with two dedicated targets: (a) 3.6 aimed at preventing road traffic deaths and injuries and (b) 11.2 providing access to safe, affordable, accessible and sustainable transport systems for all.
Achieving these targets would lead to increases in walking, cycling and using public transport, in other words, those modes of transport which impact most favorably on noncommunicable diseases like heart and lung diseases, cancer and diabetes. It would also contribute to reducing environmental risks, such as air and noise pollution, and steering sustainable urbanization, with less congestion and universal access to safe, inclusive and green public spaces.
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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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A family-based weight management program improved self-perception among obese children
Battling the childhood obesity epidemic is a priority for many researchers, as obesity during adolescence increases the risk of chronic diseases throughout life. Because obese children have lower quality of life and self-esteem, greater levels of depression and anxiety, and also face more teasing and bullying than normal-weight peers, including mental health in any intervention is necessary. To that end, researchers studied the self-perception of children participating in the Fit Families program.
Fit Families is a program based on Social Cognitive Theory delivered through the New Mexico Cooperative Extension service. The program was developed for areas of southern New Mexico lacking resources to help combat childhood obesity in a positive, culturally appropriate manner by encouraging healthy food and nutrient intake and increased physical activity. For this study, children with a body mass index at least in the 85th percentile were referred by local physicians. The final study included 46 children, ranging from 8 to 17 years of age, 43% of whom were male, and 80% of whom were Hispanic.
“With our emphasis on fun physical activity, children and parents reported enjoying the games at Fit Families. We believe this may have resulted in the children’s increased self-perception related to their athletic ability,” said Martha Archuleta, PhD, RD, lead author of the study. “Children also improved the perception of their physical appearance, possibly due to the way self-acceptance and diversity of body sizes were promoted.”
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