Your search found 132 Results

  1. 1

    Prevention of sexual transmission of Zika virus. Interim guidance update.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2016 May 30. [4] p. (WHO/ZIKV/MOC/16.1 Rev.1)

    This document is an update of guidance published on 18 February 2016 to provide advice on the prevention of sexual transmission of Zika virus.The primary transmission route of Zika virus is via the Aedes mosquito. However, mounting evidence has shown that sexual transmission of Zika virus is possible and more common than previously assumed. This is of concern due to an association between Zika virus infection and adverse pregnancy and fetal outcomes, including microcephaly, neurological complications and Guillain-Barre syndrome. The current evidence base on Zika virus remains limited. This guidance will be reviewed and the recommendations updated as new evidence emerges.
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  2. 2
    Peer Reviewed

    Comparative effectiveness of congregation- versus clinic-based approach to prevention of mother-to-child HIV transmission: Study protocol for a cluster randomized controlled trial.

    Ezeanolue EE; Obiefune MC; Yang W; Obaro SK; Ezeanolue CO; Ogedegbe GG

    Implementation Science. 2013 Jun 8; 8(62):[8]p.

    Background: A total of 22 priority countries have been identified by the WHO that account for 90% of pregnant women living with HIV. Nigeria is one of only 4 countries among the 22 with an HIV testing rate for pregnant women of less than 20%. Currently, most pregnant women must access a healthcare facility (HF) to be screened and receive available prevention of mother-to-child HIV transmission (PMTCT) interventions. Finding new approaches to increase HIV testing among pregnant women is necessary to realize the WHO/ President's Emergency Plan for AIDS Relief (PEPFAR) goal of eliminating new pediatric infections by 2015. Methods: This cluster randomized trial tests the comparative effectiveness of a congregation-based Healthy Beginning Initiative (HBI) versus a clinic-based approach on the rates of HIV testing and PMTCT completion among a cohort of church attending pregnant women. Recruitment occurs at the level of the churches and participants (in that order), while randomization occurs only at the church level. The trial is unblinded, and the churches are informed of their randomization group. Eligible participants, pregnant women attending study churches, are recruited during prayer sessions. HBI is delivered by trained community health nurses and church-based health advisors and provides free, integrated on-site laboratory tests (HIV plus hemoglobin, malaria, hepatitis B, sickle cell gene, syphilis) during a church-organized 'baby shower.' The baby shower includes refreshments, gifts exchange, and an educational game show testing participants' knowledge of healthy pregnancy habits in addition to HIV acquisition modes, and effective PMTCT interventions. Baby receptions provide a contact point for follow-up after delivery. This approach was designed to reduce barriers to screening including knowledge, access, cost and stigma. The primary aim is to evaluate the effect of HBI on the HIV testing rate among pregnant women. The secondary aims are to evaluate the effect of HBI on the rate of HIV testing among male partners of pregnant women and the rate of PMTCT completion among HIV-infected pregnant women. Discussion: Results of this study will provide further understanding of the most effective strategies for increasing HIV testing among pregnant women in hard-to-reach communities.
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  3. 3

    Indoor residual spraying: an operational manual for indoor residual spraying (IRS) for malaria transmission control and elimination.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2013. [116] p.

    This manual has been created to enhance existing knowledge and skills, and to assist malaria programme managers, entomologists and vector control and public health officers to design, implement and sustain high quality IRS programmes. Though comprehensive, this manual is not intended to replace field expertise in IRS. The manual is divided into three chapters: IRS policy, strategy and standards for national policy makers and programme managers; IRS management, including stewardship and safe use of insecticides, for both national programme managers and district IRS coordinators; IRS spray application guidelines, primarily for district IRS coordinators, supervisors and team leaders. This manual will enable national programmes to: develop or refine national policies and strategies on vector control; develop or update existing national guidelines; develop or update existing national training materials; review access and coverage of IRS programmes; review the quality and impact of IRS programmes.
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  4. 4

    HIV in Asia and the Pacific: Getting to zero.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]. Regional Support for Asia and the Pacific

    Bangkok, Thailand, UNAIDS, Regional Support for Asia and the Pacific, 2011. [144] p. (UNAIDS / 11.05E)

    This report provides the most up to date information on the HIV epidemic in the region in 2011. While the region has seen impressive gains -- including a 20% drop in new HIV infections since 2001 and a three-fold increase in access to antiretroviral therapy since 2006 -- progress is threatened by an inadequate focus on key populations at higher risk of HIV infection and insufficient funding from both domestic and international sources.
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  5. 5
    Peer Reviewed

    Extreme condition, extreme measures? Compliance, drug resistance, and the control of tuberculosis.

    Harper I

    Anthropology and Medicine. 2010 Aug; 17(2):201-214.

    This paper explores the issue of compliance by focusing on the control of tuberculosis. In the last ten years, patient compliance in tuberculosis control has discursively shifted from 'direct observation' of therapy to more patient-centred focus and support drawing on rights-based approaches in dealing with health care provision. At the same time, there has been an increased international concern with the rise of drug resistant forms of tuberculosis, and how to manage this. This paper looks at these issues and the tensions between them, by discussing the shift in discourses around the two and how they relate. Drawing on experience from work in Nepal, and its successful tuberculosis control programme, it looks at debates around this and how these two arenas have been addressed. The rise of increasingly drug resistant forms of tuberculosis has stimulated the development of new WHO and other guidelines addressing how to deal with this problem. The links between public health, ethics and legal mandate are presented, and the implications of this for controlling transmission of drug resistant disease, on the one hand, and the drive for greater patient support mechanisms on the other. Looking forwards to uncertain ethical and public health futures, these issues will be mediated by emergent WHO and international frameworks.
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  6. 6

    Guidelines for the treatment of malaria. Second edition.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2010. [211] p.

    The World Health Organization Guidelines for the treatment of malaria provides evidence-based and up-to-date recommendations for countries on malaria diagnosis and treatment which help countries formulate their policies and strategies. In scope, the Guidelines cover the diagnosis and treatment of uncomplicated and severe malaria caused by all types of malaria, including in special groups (young children, pregnant women, HIV / AIDS), in travellers (from non-malaria endemic regions) and in epidemics and complex emergency situations. The first edition of the Guidelines for the treatment of malaria were published in 2006. The second edition introduces a new 5th ACT to the four already recommended for the treatment of uncomplicated malaria. Furthermore, the Guidelines recommend a parasitological confirmation of diagnosis in all patients suspected of having malaria before treating. The move towards universal diagnostic testing of malaria is a critical step forward in the fight against malaria as it will allow for the targeted use of ACTs for those who actually have malaria. This will help to reduce the emergence and spread of drug resistance. It will also help identify patients who do not have malaria, so that alternative diagnoses can be made and appropriate treatment provided. The new Guidelines will therefore help improve the management of not only malaria, but other childhood febrile illnesses.
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  7. 7

    Progress in measles control: Nepal, 2000 -- 2006.

    Weekly Epidemiological Record. 2007 Oct; 82(40):345-356.

    In 2002, the United Nations Special Session on Children set the goal of reducing the number of deaths caused by measles by half between 1999 and 2005. Nepal adopted the WHO/UNICEF comprehensive strategy for sustainable measles mortality reduction in 2003; this strategy has the goal of reducing by 50% the number measles deaths in the country by 2005 compared with the number in 2003. This report summarizes efforts made to strengthen routine childhood immunization, the implementation of measles supplementary immunization activities (SIAs) and reviews measles surveillance data from 2000 to 2006, which demonstrate a significant decrease in the reported incidence of measles in Nepal. (excerpt)
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  8. 8
    Peer Reviewed

    Advancement of global health: key messages from the Disease Control Priorities Project.

    Laxminarayan R; Mills AJ; Breman JG; Measham AR; Alleyne G

    Lancet. 2006 Apr 8; 367(9517):1193-1208.

    The Disease Control Priorities Project (DCPP), a joint project of the Fogarty International Center of the US National Institutes of Health, the WHO, and The World Bank, was launched in 2001 to identify policy changes and intervention strategies for the health problems of low-income and middle-income countries. Nearly 500 experts worldwide compiled and reviewed the scientific research on a broad range of diseases and conditions, the results of which are published this week. A major product of DCPP, Disease Control Priorities in Developing Countries, 2nd edition (DCP2), focuses on the assessment of the cost-effectiveness of health-improving strategies (or interventions) for the conditions responsible for the greatest burden of disease. DCP2 also examines crosscutting issues crucial to the delivery of quality health services, including the organisation, financial support, and capacity of health systems. Here, we summarise the key messages of the project. (author's)
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  9. 9

    Neglected tropical diseases, hidden successes, emerging opportunities.

    World Health Organization [WHO]. Department of Control of Neglected Tropical Diseases

    Geneva, Switzerland, WHO, Department of Control of Neglected Tropical Diseases, 2006. [49] p. (WHO/CDS/NTD/2006.2)

    Neglected tropical diseases affect an estimated 1 billion people, primarily poor populations living in tropical and subtropical climates. They frequently cluster geographically and overlap; individuals are often afflicted with more than one parasite or infection. 100% of low-income countries are affected by at least five neglected tropical diseases simultaneously. More than 70% of countries and territories that report the presence of neglected tropical disease are low-income and lower middle-income economies. Infections are attributable to unsafe water, poor housing conditions and poor sanitation. Children are most vulnerable to infections of most neglected tropical diseases. Neglected tropical diseases kill, impair or permanently disable millions of people every year, often resulting in life-long physical pain, social stigmatization and abuse. Many can be prevented, eliminated or even eradicated with improved access to existing safe and costeffective tools. (excerpt)
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  10. 10
    Peer Reviewed

    Water and sanitation: the neglected health MDG.

    Lancet. 2006 Oct 7; 368(9543):1212.

    A joint report from UNICEF and WHO published last month showed that 1.1 billion people do not have access to clean water and 2.6 billion people do not have access to basic sanitation. Last week, UNICEF launched its own report card on water and sanitation giving detailed statistics from each global region. It is grim reading despite UNICEF's optimism that some regions may now be on track to meet the water target in the seventh Millennium Development Goal--to halve the proportion of people without sustainable access to safe drinking water and sanitation by 2015. Some areas, such as rural sub-Saharan Africa, lag way behind on the water target, and most regions are failing spectacularly on sanitation targets. The report's headline statistic is that 1.5 million children die every year from preventable diarrhoeal illnesses and many thousands more are disadvantaged by wide-reaching health and educational consequences because of these failings. Unfortunately, experience to date suggests that statistics like this numb the mind rather than shock it into action as there is a distinct lack of political will to do more. (excerpt)
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  11. 11
    Peer Reviewed

    Watching the world wash its hands of sanitation.

    Lancet Infectious Diseases. 2006 Oct; 6(10):615.

    A leading expert recently expressed an ambitious view that waterborne infectious diseases could be consigned to history. Alan Fenwick (Imperial College, UK) points out that the continual donation of drugs and other inexpensive treatments by a number of effective global health partnerships could control many waterborne and vectorborne diseases effectively by 2015, which is the target for reaching the Millennium Development Goals (MDGs). He insists that treatment will substantially reduce disease morbidity, while also lowering overall disease transmission. However, disease transmission will still continue unless we tackle the root causes of these diseases, which are poor access to safe water and basic sanitation. A new joint WHO/UNICEF report on the progress towards meeting the water and sanitation MDG targets provides grim reading. The report states that the world is barely on track to reducing the proportion of people without sustainable access to safe drinking water, and the sanitation target is likely to be missed entirely. By 2015, if the current trends continue, over 900 million people will not have access to safe drinking water and 2.4 billion people will be without access to basic sanitation. According to the report, current efforts need to be stepped up by almost a third to meet the water target and almost doubled to meet the sanitation target. (excerpt)
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  12. 12

    Time running out for saving lives [editorial]

    SAfAIDS News. 2005 Sep; 11(3):2.

    Most people living with HIV and AIDS (PLWHA) are found in severely resource-constrained settings, where the pandemic continues to grow at an alarming rate, throwing into disarray the already enormous treatment challenge. High AIDS mortality rates are mainly experienced in sub-Saharan Africa, particularly in the southern Africa region. Yet recent events paint a gloomy picture regarding financial support for international remedial efforts against HIV and AIDS. There is uncertainty over continued funding of AIDS programmes in the future, forcing us to ask tough questions such as whether the aim of providing antiretroviral therapy (ART) to individuals clinically qualified to receive these medicines will be feasible and whether it will be possible to retain those already on treatment in the future. (excerpt)
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  13. 13

    The significance of insecticide-resistant strains.

    Busvine JR

    Bulletin of the World Health Organization. 1956; 15:389-401.

    The author discusses the meaning of insecticide resistance and the manner in which it should be detected and measure. From some recent data he gives a number of examples of measurements of resistance in mosquitos of different species in various areas. He then proceeds to a speculative discussion on the way in which insecticide resistance arises, whether it can be prevented and overcome, its importance in the past and at present, and finally its future prospects. (excerpt)
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  14. 14

    Nozzles of insecticide sprayers. Comments from the point of view of malaria control.

    Knipe FW

    Bulletin of the World Health Organization. 1955; 12:401-409.

    Certain performance characteristics of the insecticide-sprayer nozzle tip and its relationship to the pressure regulator are discussed. After analysing the effectiveness of residual spraying at various pressures, the author concludes that low-pressure application would best attain the pattern and rate of insecticide discharge laid down by the WHO Expert Committee on Insecticides. (excerpt)
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  15. 15
    Peer Reviewed

    Changing strategy in malaria control.

    Pampana EJ

    Bulletin of the World Health Organization. 1954; 11:513-520.

    Residual-insecticide spraying methods may lead to the eradication of malaria from a country or from an area of it, and therefore to the possibility that the spraying campaign may eventually be discontinued. This is the final target to be aimed at in planning national malaria-control campaigns. As it is now known that some anopheline vector species may develop resistance to insecticides, a plea is made that control programmes should be planned to cover such large areas and with such criteria of efficiency as to eradicate malaria and to enable the campaign to be discontinued before resistance may have developed. (author's)
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  16. 16
    Peer Reviewed

    Global public health surveillance under new international health regulations.

    Baker MG; Fidler DP

    Emerging Infectious Diseases. 2006 Jul; 12(7):1058-1065.

    The new International Health Regulations adopted by the World Health Assembly in May 2005 (IHR 2005) represents a major development in the use of international law for public health purposes. One of the most important aspects of IHR 2005 is the establishment of a global surveillance system for public health emergencies of international concern. This article assesses the surveillance system in IHR 2005 by applying well-established frameworks for evaluating public health surveillance. The assessment shows that IHR 2005 constitutes a major advance in global surveillance from what has prevailed in the past. Effectively implementing the IHR 2005 surveillance objectives requires surmounting technical, resource, governance, legal, and political obstacles. Although IHR 2005 contains some provisions that directly address these obstacles, active support by the World Health Organization and its member states is required to strengthen national and global surveillance capabilities. (author's)
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  17. 17

    Tuberculosis care and control [editorial]

    Hopewell PC; Migliori GB; Raviglione MC

    Bulletin of the World Health Organization. 2006 Jun; 84(6):428.

    Tuberculosis care, a clinical function consisting of diagnosis and treatment of persons with the disease, is the core of tuberculosis control, which is a public health function comprising preventive interventions, monitoring and surveillance, as well as incorporating diagnosis and treatment. Thus, for tuberculosis control to be successful in protecting the health of the public, tuberculosis care must be effective in preserving the health of individuals. There are three broad mechanisms through which tuberculosis care is delivered: public sector tuberculosis control programmes, private sector practitioners having formal links to public sector programmes (the public--private mix), and private providers having no connection with formal activities. In most countries, programmes in both the public sector and the public--private mix are guided by international and national recommendations based on the DOTS tuberculosis control strategy -- a systematic approach to diagnosis, standardized treatment regimens, regular review of outcomes, assessment of effectiveness and modification of approaches when problems are identified. (excerpt)
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  18. 18

    Report on series of workshops "Leadership for Results". UNDP in Ukraine. May, 24-31 2004.

    United Nations Development Programme [UNDP]

    [Kyiv], Ukraine, UNDP, 2004. [61] p.

    The United Nations Development Program (UNDP) organized a series of "Leadership for Results" workshops on May 24-31 2004 to develop and boost leadership skills of several participants' categories: trade union leaders, public figures, physicians, women-leaders, Peer Education Program trainers, etc. Allan Henderson, who facilitated this workshop, pointed out that "these workshops are not meant to make leaders of those who are not leaders, but rather to provide the opportunity for people who already are leaders to step out of the day-to-day business and address their own development." The task for participants is to improve themselves and society, to get to the higher leadership level, to develop more holistic outlook and support leadership skills with more comprehensive background. The structure of this leadership workshop stipulates three meetings with three months intervals. Methods applied in the workshop are as follows: education (knowledge transfer); training (practice of skill development) and coaching (establishing new opportunities for the future). The first workshop on May 24-25 that UNDP held jointly with the International Labor Organization (ILO) welcomed over 70 leaders from four most active trade union associations in Ukraine. It was just recently that trade unions started paying attention to the problem of HIV/AIDS. For the majority of participants it was their first workshop. (excerpt)
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  19. 19

    Global tuberculosis control: surveillance, planning, financing. WHO report 2005.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2005. [255] p. (WHO/HTM/TB/2005.349)

    The goal of this series of annual reports is to chart progress in global TB control and, in particular, to evaluate progress in implementing the DOTS strategy. The first targets set for global TB control were ratified in 1991 by WHO’s World Health Assembly. They are to detect 70% of new smearpositive TB cases, and to successfully treat 85% of these cases. Since these targets were not reached by the end of year 2000 as originally planned, the target year was deferred to 2005.4 In 2000, the United Nations created a new framework for monitoring progress in human development, the MDGs. Among 18 MDG targets, the eighth is to “have halted by 2015 and begun to reverse the incidence of malaria and other major diseases”. Although the objective is expressed in terms of incidence, the MDGs also specify that progress should be measured in terms of the reduction in TB prevalence and deaths. The target for these two indicators, based on a resolution passed at the 2000 Okinawa (Japan) summit of G8 industrialized nations, and now adopted by the Stop TB Partnership, is to halve TB prevalence and death rates (all forms of TB) between 1990 and 2015. All three measures of impact (incidence, prevalence and death rates) have been added to the two traditional measures of DOTS implementation (case detection and treatment success), so that the MDG framework includes five principal indicators of progress in TB control. All five MDG indicators will, from now on, be evaluated by WHO’s Global TB Surveillance, Planning and Financing Project. The focus is on the performance of NTPs in 22 HBCs, and in priority countries in WHO’s six regions. (excerpt)
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  20. 20
    Peer Reviewed

    The human right to the highest attainable standard of health: new opportunities and challenges.

    Hunt P

    Transactions of the Royal Society of Tropical Medicine and Hygiene. 2006 Jul; 100(7):603-607.

    The health and human rights communities have much in common. Recently, the international community has begun to devote more attention to the right to the highest attainable standard of health (‘the right to health’). Today, this human right presents health and human rights professionals with a range of new opportunities and challenges. The right to health is enshrined in binding international treaties and constitutions. It has numerous elements, including the right to health care and the underlying determinants of health, such as adequate sanitation and safe water. It empowers disadvantaged individuals and communities. If integrated into national and international policies, it can help to establish policies that are meaningful to those living in poverty. The author introduces his work as the UN Special Rapporteur on the right to health. By way of illustration, he briefly considers his interventions on Niger’s Poverty Reduction Strategy, Uganda’s neglected (or tropical or poverty-related) diseases, and the recent US—Peru trade negotiations. With the maturing of human rights, health professionals have become an indispensable part of the global human rights movement. While human rights do not provide magic solutions, they have a constructive contribution to make. The failure to use them is a missed opportunity of major proportions. (author's)
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  21. 21
    Peer Reviewed

    Four malaria success stories: how malaria burden was successfully reduced in Brazil, Eritrea, India, and Vietnam.

    Barat LM

    American Journal of Tropical Medicine and Hygiene. 2006 Jan; 74(1):12-16.

    While many countries struggle to control malaria, four countries, Brazil, Eritrea, India, and Vietnam, have successfully reduced malaria burden. To determine what led these countries to achieve impact, published and unpublished reports were reviewed and selected program and partner staff were interviewed to identify common factors that contributed to these successes. Common success factors included conducive country conditions, a targeted technical approach using a package of effective tools, data-driven decision-making, active leadership at all levels of government, involvement of communities, decentralized implementation and control of finances, skilled technical and managerial capacity at national and sub-national levels, hands-on technical and programmatic support from partner agencies, and sufficient and flexible financing. All these factors were essential in achieving success. If the goals of Roll Back Malaria are to be achieved, governments and their partners must take the lessons learned from these program successes and apply them in other affected countries. (author's)
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  22. 22

    The state of the world's children, 2006. Excluded and invisible.


    New York, New York, UNICEF, 2005 Dec. [152] p.

    Millions of children make their way through life impoverished, abandoned, uneducated, malnourished, discriminated against, neglected and vulnerable. For them, life is a daily struggle to survive. Whether they live in urban centres or rural outposts, they risk missing out on their childhood - excluded from essential services such as hospitals and schools, lacking the protection of family and community, often at risk of exploitation and abuse. For these children, childhood as a time to grow, learn, play and feel safe is, in effect, meaningless. It is hard to avoid the conclusion that we, the adults of the world, are failing in our responsibility to ensure that every child enjoys a childhood. Since 1924, when the League of Nations adopted the Geneva Declaration of the Rights of the Child, the international community has made a series of firm commitments to children to ensure that their rights - to survival, health, education, protection and participation, among others - are met. The most far-reaching and comprehensive of these commitments is the Convention on the Rights of the Child, adopted by the UN General Assembly in 1989 and ratified by 192 countries. As the most widely endorsed human rights treaty in history, the Convention, together with its Optional Protocols, lays out in specific terms the legal duties of governments to children. Children's survival, development and protection are now no longer matters of charitable concern but of moral and legal obligation. Governments are held to account for their care of children by an international body, the Committee on the Rights of the Child, to which they have agreed to report regularly. (excerpt)
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  23. 23

    The MDGs: condoms as disease prevention, not just contraception [editorial]

    Ratzan SC

    Journal of Health Communication. 2005; 10:375-378.

    The review of the UN Millennium Development Goals (MDGs) this fall poses an opportunity to focus on and galvanize interest in health development. The MDGs are a framework of 8 goals, 18 targets, and 48 indicators with a target goal for attainment of 2015. These development goals were adopted by a consensus of experts from the United Nations Secretariat and the International Monetary Fund (IMF), organisation for Economic Co-operation and Development (OECD), and the World Bank. While health is directly reflected in three of the eight MDGs and eight of the 18 accompanying indicators, progress is choppy. Of course, the linkage of health as the foundation for the achievement of all the MDGs may seem to be an obvious antecedent as well as a sequela for development. No single pathogen or disease, however, appears to be ravaging unabated more than HIV=AIDS. HIV=AIDS continues to pose a significant drag on development indicators of those countries most affected. It has become a fundamental threat, not only to the health—and survival—of more than 25 million currently infected individuals in Africa, but also to the entire health system and workforce as well as overall governance, security, education, debt relief, economic development, and peace. (excerpt)
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  24. 24

    Operation "restore order" wreaks havoc in Zimbabwe.

    Kapp C

    2005 Oct 1; 366:1151-1152.

    Aid organisations are fighting an uphill battle to help victims of Zimbabwe’s disastrous Operation Restore Order which, according to UN envoy Anna Tibaijuka, left an estimated 700 000 people without a home or livelihood and caused chaos and suffering “on an unprecedented scale”. The clampdown on slum dwellers and street traders—ostensibly to tackle crime—added to the humanitarian nightmares in the southern African nation where more than one-third of the population will soon be dependent on food aid; where HIV/AIDS rates of some 25% are expected to rise; and where life expectancy has plummeted to 33 years. Although the UN launched urgent appeals for drought-stricken neighbouring countries like Malawi and Mozambique, its efforts to aid victims of Operation Restore Order have been frustrated by the Zimbabwean government. (excerpt)
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  25. 25
    Peer Reviewed

    Who takes responsibility for Zimbabwe?

    Lancet. 2005 Oct 1; 366:1138.

    Zimbabwe is in crisis. Since May, Operation Murambatsvina (“drive away rubbish”) has led to the forced evictions and demolition of communities countrywide, leaving hundreds of thousands of people homeless. This mass destruction has exacerbated the problems of drought and malnutrition, increased the devastation of HIV/AIDS, and worsened national economic meltdown. A UN report has estimated that over 79 500 people with HIV/AIDS were among those evicted, disrupting home-based care, and Zimbabwe’s antiretroviral programme. The crucial issue of adherence to drug regimens has been seriously threatened. In public-sector antiretroviral programmes, it is estimated that 30% of patients have experienced a break in drug supplies of at least 2 weeks. 2 weeks is enough to further the development of clinically significant resistance to nevirapine, the cornerstone of the government’s firstline antiretroviral protocol. Interruption in treatment— coupled with the disruption to social and safety mechanisms, overcrowding, lack of access to clean water, food, and shelter, especially with the onset of winter looming—make the sick even more vulnerable. (excerpt)
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