Your search found 11 Results
Towards universal access: scaling up priority HIV / AIDS interventions in the health sector. Progress report, April 2007.
Geneva, Switzerland, WHO, 2007 Apr. 88 p.Drawing on lessons from the scale-up of HIV interventions over the last few years, WHO, as the UNAIDS cosponsor responsible for the health sector response to HIV/AIDS, has established priorities for its technical work and support to countries on the basis of the following five Strategic Directions, each of which represents a critical area where the health sector must invest if significant progress is to be made towards achieving universal access. Enabling people to know their HIV status; Maximizing the health sector's contribution to HIV prevention; Accelerating the scale-up of HIV/AIDS treatment and care; Strengthening and expanding health systems; Investing in strategic information to guide a more effective response. In this context, WHO undertook at the World Health Assembly in May 2006 to monitor and evaluate the global health sector response in scaling up towards universal access and to produce annual reports. This first report addresses progress in scaling up the following health sector interventions. Antiretroviral therapy; Prevention of mother-to-child transmission of HIV (PMTCT); HIV testing and counseling; Interventions for injecting drug users (IDUs); Control of sexually transmitted infections (STIs) to prevent HIV transmission; Surveillance of the HIV/AIDS epidemic. (excerpt)
Journal of Tropical Pediatrics. 2007 Jun; 53(3):147-149.Tuberculosis (TB) kills about 2 million adults and around 100 000 children every year. One-third of the world's population are currently infected with Mycobacterium tuberculosis and many have active disease. In Europe TB emerged as a major disease in the latter part of the 14th century. The industrial revolution saw rapid growth of urban centres where overcrowding with poor living conditions provided ideal circumstances for the spread of the disease. Great impact was made by streptomycin and isoniazid, so that by the 1970s TB was no longer being considered a problem in the developed world. But beginning in the 1980s the number of new cases of TB in USA and across Europe rose sharply. The pattern was repeated in many countries and worldwide throughout the 1990s and into the new millennium. The incidence of TB climbed to over 9 million cases every year. In 1993 the World Health Organization (WHO) declared TB as a global emergency. During the 1990s multidrug resistant tuberculosis (MDR-TB), defined as resistance to at least isoniazid and rifampicin, emerged as a threat to TB control. MDR-TB requires the use of second line drugs that are less effective, more toxic and costlier. In a global survey of 17 690 TB isolates during 2000-04, 20% were MDR and 2% were extremely drug resistant (XDR). XDR-TB is defined as MDR plus resistance to any fluoroquinolones and at least one of three injectable second line drugs kanamycin and amikacin, or capreomycin or both. Currently one in ten new infections is resistant to at least one antituberculosis drug. (excerpt)
Engaging all health care providers in TB control. Guidance on implementing public-private mix approaches.
Geneva, Switzerland, World Health Organization [WHO], Stop TB Department, 2006. 52 p. (WHO/HTM/TB/2006.360)A great deal of progress has been made in global tuberculosis control in recent years through the large-scale implementation of DOTS. It has been acknowledged though that TB control efforts worldwide, although impressive, are not sufficient. The global TB targets -- detecting 70% of TB cases and successfully treating 85% of them, and halving the prevalence and mortality of the disease by 2015 as part of the Millennium Development Goals (MDGs) -- are likely to be met only if current efforts are intensified. Among the important interventions required to reach these goals would be a systematic involvement of all relevant health care providers in delivering effective TB services to all segments of the population. Therefore, engaging all health care providers in TB control is an essential component of WHO's new Stop TB strategy¹ and the Stop TB Partnership's Global Plan to Stop TB 2006-2015. (excerpt)
Washington, D.C., Population Reference Bureau [PRB], 2006 Apr. 5 p.As if the global AIDS pandemic alone were not enough, developing countries are beset with converging epidemics of HIV and tuberculosis (TB)--increasing the likelihood of premature death in these countries. Worldwide, 14 million people are coinfected with TB and HIV--70 percent of those in sub-Saharan Africa (see figure for five countries with particularly high coinfection rates). TB is the leading cause of death for those infected with HIV and is implicated in up to one-half of all AIDS deaths. And because HIV compromises the immune system, HIV-positive people are 50 times more likely to develop active TB than those who are HIV-negative. (excerpt)
National adult antiretroviral therapy guidelines in South Africa: concordance with 2003 WHO guidelines?
AIDS. 2007 Jan 2; 21(1):121-122.We read with interest the article by Beck and colleagues who examined the adult antiretroviral therapy (ART) guidelines in 43 World Health Organization (WHO) '3 by 5' focus countries. The authors found that the national guidelines of a majority of countries had a good degree of concordance with the WHO 2003 guidelines. Although concordance was noted to be inversely related to health expenditure per capita, the authors did not further explore the reasons why some countries have adopted guidelines that differ from the current WHO recommendations. One such country is South Africa, which has among the highest per capita income of countries in sub-Saharan Africa and also has much better healthcare infrastructure than most. Despite these resources, the South African national ART programme currently bases its treatment guidelines on the former WHO 2002 guidelines that recommend ART only for patients with WHO stage 4 disease (AIDS) or a blood CD4 cell count of less than 200 cells/ml. We believe these guidelines advocate treatment at too late a stage of disease and that they represent a compromise that may substantially undermine the effectiveness of the programme in the long term. (excerpt)
WHO clinical staging of HIV infection and disease, tuberculosis and eligibility for antiretroviral treatment: relationship to CD4 lymphocyte counts.
International Journal of Tuberculosis and Lung Disease. 2005 Mar; 9(3):258-262.Setting: Thyolo district, Malawi. Objectives: To determine in HIV- positive individuals aged over 13 years CD4 lymphocyte counts in patients classified as WHO Clinical Stage III and IV and patients with active and previous tuberculosis (TB). Design: Cross-sectional study. Methods: CD4 lymphocyte counts were determined in all consecutive HIV-positive individuals presenting to the antiretroviral clinic in WHO Stage III and IV. Results: A CD4 lymphocyte count of =350 cells/µl was found in 413 (90%) of 457 individuals in WHO Stage III and IV, 96% of 77 individuals with active TB, 92% of 65 individuals with a history of pulmonary TB (PTB) in the last year, 91% of 89 individuals with a previous history of PTB beyond 1 year, 81% of 32 individuals with a previous history of extra-pulmonary TB, 93% of 107 individuals with active or past TB with another HIV-related disease and 89% of 158 individuals with active or past TB without another HIV-related disease. Conclusions: In our setting, nine of 10 HIV-positive individuals presenting in WHO Stage III and IV and with active or previous TB have CD4 counts of =350 cells/µl. It would thus be reasonable, in this or similar settings where CD4 counts are unavailable for clinical management, for all such patients to be considered eligible for antiretroviral therapy. (author's)
Manila, Philippines, WHO, Regional Office for the Western Pacific, Stop TB, 2004.  p.Globally, over 98% of the deaths caused by tuberculosis (TB) annually are in developing countries. Within the Western Pacific Region, the seven countries that account for 94% of the TB prevalence are low or lower middle-income economies. Within countries, as well, poor and marginalized communities suffer disproportionately from TB. Importantly, TB affects the most economically and socially productive age group, as 77% of TB deaths occur within the ages of 15 – 54. This evidence points to the important relationship between poverty and TB. The deprivation associated with poverty, such as overcrowding, poor ventilation and malnutrition, increases the rate of transmission and progression from infection to disease. In turn, the costs of TB can further impoverish poor households. This is because poor households must dedicate a larger proportion of their income to meet the direct and indirect costs of seeking TB care than the non-poor. The opportunity costs are likewise higher for the poor than non-poor. For the poor, a decrease in productivity or an increase in time away from work because of illness leads to a reduction in income. Moreover, coping mechanisms employed by poor households during periods of illness may reduce household productivity in the long-term. TB has important social costs as well, which are more likely to affect women with TB than men. For example, stigma and isolation resulting from TB can reduce an individual's social position. (excerpt)
Geneva, Switzerland, WHO, Department of HIV / AIDS, 2002 Sep. 31 p. (WHO/HIV/2002.18)The development of effective and sustainable health systems has always underpinned the work of WHO. Recognizing the enormous task demanded of countries and their health services, WHO has significantly expanded its ability to support them and to lead the response of the health sector to this epidemic. This report outlines WHO’s work and achievements on HIV/AIDS in four major areas: development of global strategy and policy; development of normative tools and guidance; improving knowledge of the epidemic and the responses of the health sector; and providing technical support to countries and relevant organizations. These aspects of WHO’s work, though by no means exhaustive, reflect its major priorities in HIV/AIDS and the reorganization and expansion that have occurred within WHO to meet these priorities. The restructured and expanded Department of HIV/AIDS, the organization-wide response, and improved interdepartmental coordination are intended to offer countries the rigorous and wide-ranging guidance and support they require in scaling up their own responses. (excerpt)
Lancet Infectious Diseases. 2003 Sep 1; 3(9):530.According to Raviglione the antituberculosis drugs used with the directly observed therapy short-couse (DOTS) made it possible to cure tuberculosis in over 80 000 Africans living with HIV last year. However more than 200 000 Africans with HIV died from tuberculsosis because they had no access to anti-tuberculosis drugs and DOTS. Tuberculosis was notably absent from the scientific programme at the HIV meeting. “In Africa it strikes us as peculiar how politicians and academics can speak of their ‘AIDS initative’ or ‘their tuberculosis programme’ as if the two diseases are not related,” said Winstone Zulu, a Zambian man infected with HIV, who had been recently cured of tuberculosis. “We see them together conspiring and collaborating to steal away our health.” (excerpt)
Tropical Medicine and International Health. 2002 Nov; 7(11):970-976.Public–private partnerships have become central to efforts to combat infectious diseases. The characteristics of specific partnerships, their governance structures, and their ability to effectively address the issues for which they are developed are being clarified as experience is gained. In an attempt to promote access to and rational use of second-line anti-tuberculosis (TB) drugs for the treatment of multidrug-resistant TB, a unique partnership known as the Green Light Committee (GLC) was established by the World Health Organization. This partnership relies on five categories of actors to achieve its goal: academic institutions, civil society organizations, bilateral donors, governments of resource-limited countries, and a specialized United Nations agency. While the for-profit private sector is involved in terms of supplying concessionally priced drugs it is excluded from decision-making. The effectiveness of the partnership emerges from its review process, flexibility to modify its modus operandi to overcome obstacles, independence from the commercial sector, and its ability to link access, rational use, technical assistance, and policy development. The GLC mechanism may be useful in the development of other partnerships needed in the rational allocation of resources and tools for combating additional infectious diseases. (author’s)
VACCINE. 1988 Oct; 6(5):393-8.In developing countries, where economic development is lacking and literacy rates are low, priority must be given to primary health care and to the establishmend of sustainable health care delivery systems. The World Health Organization's Expanded Program of Immunization was designed with the goal of immunizing all children against measles, pertussis, tetanus, poliomyelitis, tuberculosis, and diphtheria by 1990. A second function of the immunization program is to establish a health care delivery system. Today 50% of infants receive 3 doses of diptheria/pertussis/tetanus and polio vaccines, and 70% receive at least 1 dose. Measles kills 2 million children every year. The standard strain of attenuated vaccine is given at 9 months, and 1 dose protects 95% of children for life. Tetanus kills 800,000 infants every year. The vaccine must be refrigerated, and 2 doses are essential. Tuberculosis kills 2 million children under 5 every year. The attenuated BCG vaccine should be given at birth, and a single dose confers some protection. Diphtheria is most common among poor, urban children in termperate climates, and 3 doses of toxoid at monthly intervals are recommended. Poliomyelitis paralyzes 250,000 children a year. 4 doses of live attenuated Sabin vaccine are recommended. The vaccine is very sensitive to heat. Other vaccines in use or being developed include yellow fever, meningococcus, Japanese B encephalitis, rubella, hepatitis B, cholera, rotavirus, pneumonococcus, and Haemophilus influezae. 2 problems that confront the delivery of health services, including immunization, are lack of funds and lack of access to susceptible populations. Approaches to the lack of funds problem include fee for service, taxation, beter management of existing resources, reallocation of health resources, and increased funding from donor nations. Approaches to the problem of access include vaccination whenever children come into contact with a health facility for any reason, channeling by members of the community, involvement of traditional healers and birth attendants, outreach services, mass campaigns, pulse technics, and financial incentives.