Improvements in health cannot be achieved in isolation as they require an integrated, multisectorial development approach. The WHO's Regional Office for the Eastern Mediterranean has introduced the following community-based initiatives: basic development needs approach; healthy villages programme; healthy cities programme; women in health and development. These community-based initiatives have provided a stimulus for health and human development. This training manual provides material to help develop trainers; update the knowledge of field managers; and reinforce leadership and management skills.
This "Manual" is intended to help producers, regulators, trainers and others concerned with the safety of traditional foods in the Eastern Mediterranean Region, and may be used as material for training in food hygiene and the HACCP system, as well as the basis for the development of food safety programs. It is expected that most producers of the foods covered in this manual will have little or no knowledge of the HACCP system, so to expect them to implement the relevant models alone would not be realistic. Rather, governmental or nongovernmental agencies engaged in health, food control, or safety of the environment will need to help groups of producers in implementing the models in their plants. This manual covers just a few of the many traditional foods of the Region. It is hoped that that countries will develop and share generic HACCP models for other traditional foods in the Region so that a second edition can follow.
The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new guidelines were adopted and recommended for use, in addition to 20 monographs and general texts for inclusion in The International Pharmacopoeia and 11 new International Chemical Reference Substances. The International Pharmacopoeia - updating mechanism for the section on radiopharmaceuticals; WHO good manufacturing practices for pharmaceutical products: main principles; Model quality assurance system for procurement agencies; Assessment tool based on the model quality assurance system for procurement agencies: aide-memoire for inspection; Guidelines on submission of documentation for prequalification of finished pharmaceutical products approved by stringent regulatory authorities; and Guidelines on submission of documentation for a multisource (generic) finished pharmaceutical product: quality part.
The World Health Organization (WHO) Expert Committee on Specifications for Pharmaceutical Preparations advises the Director-General of WHO in the area of medicines quality assurance. It provides independent expert recommendations and guidance to ensure that medicines meet standards of quality safety and efficacy in all WHO Member States. Its advice is developed through a broad consensus-building process and covers all areas of quality assurance of medicines from their development to their distribution to patients. In the area of quality control the Expert Committee reviewed new and revised specifications and general texts for inclusion in The International Pharmacopoeia and received the annual report of the European Directorate for the Quality of Medicines & HealthCare (EDQM) the custodian centre for International Chemical Reference Substances (ICRS). The Committee adopted a number of monographs general texts and ICRS. It noted the report on Phase 5 of the External Quality Assurance Assessment Scheme (EQAAS) and on new approaches to ensure sustainability of this scheme through user fees. The Committee further received a concept paper on the benefits of good pharmacopoeial practices (GPhP) and was informed of progress achieved with developing a comprehensive document on GPhP through discussions at consecutive international meetings of world pharmacopoeias. In the various quality assurance-related areas the Expert Committee was presented with a number of new and revised guidelines related to good manufacturing practices (GMP) distribution and trade of pharmaceuticals and regulatory practice. It adopted eight guidelines and 16 technical supplements as listed below including a new guidance text on good review practice prepared under the leadership of the Asian-Pacific Economic Cooperation Regulatory Harmonization Steering Committee. The Committee took note of ongoing work to promote collaboration and information exchange through the good regulatory practice project and welcomed the development of a comprehensive set of guidelines for all national regulatory authorities through this project. The report includes the following annexes which are recommended as new WHO guidelines: . Annex 1. Procedure of the development of monographs for inclusion in The International Pharmacopoeia (revision); . Annex 2. Updating mechanism for the section on radiopharmaceuticals in The International Pharmacopoeia (revision); . Annex 3. Supplementary guidelines on good manufacturing practices: validation; Appendix 7: non-sterile process validation (revision); . Annex 4. General guidance for inspectors on hold-time studies (new); . Annex 6. Recommendations for quality requirements when plant-derived artemisinin is used as a starting material in the production of antimalarial active pharmaceutical ingredients (revision); . Annex 7. Guidelines on registration requirements to establish interchangeability (revision); . Annex 8. Guidance on the selection of comparator pharmaceutical products for equivalence assessment of interchangeable multisource (generic) products (revision); . Annex 9: Good review practices guidelines for regulatory authorities (new). In addition 16 technical supplements to the WHO model guidance for the storage and transport of time- and temperature-sensitive pharmaceutical products were adopted for publication in a format which is appropriate to the large volume of this guidance (Annex 5). The newly adopted monographs were adopted for inclusion in The International Pharmacopoeia. Following the implementation of the revised general monograph on parenteral preparations the Committee adopted the proposed endotoxin limits for 11 parenteral dosage form monographs lacking such specification together with related updates to relevant monographs. The Committee adopted 12 ICRS newly characterized by the custodian centre EDQM. The Committee further adopted the workplan for new monographs to be included in The International Pharmacopoeia.
This manual presents an overview of iodine deficiency disorders (IDD) and provides detailed instructions in the monitoring and evaluation of IDD control and prevention programs. Health and nutrition program staff working at the provincial, district and field levels in the public health sector will find this guide particularly useful. It may also be used by interested iodized salt producers and those involved in the formulation of health and nutrition policy and programs. The manual provides information on the selection of appropriate process and impact indicators and techniques on conducting IDD program assessments.
This report presents the conclusions of a WHO Expert Committee commissioned to make recommendations on specifications for pesticides used in public health. The aim is to promote the manufacture and use of high quality products that are both acceptable in terms of public health and effective against susceptible vectors of disease. The text includes an outline of the WHO Pesticide Evaluation Scheme (WHOPES) and an overview of recent trends in the various WHO regions.
Elimination of the residual foci of malaria transmission is a dynamic process, taking place mainly during the late stage of the attack and consolidation phases of malaria elimination. This approach is suitable for countries or areas that are targeting interruption of malaria transmission in their territories. Countries can plan for a selective elimination of P. falciparum foci in the first stage, to be expanded to P. vivax at a later stage when more resources and a stronger program are available. During the past 15 years several national malaria programs in the WHO Eastern Mediterranean Region adopted elimination strategies. It is the vision of the Regional Office for the Eastern Mediterranean to expand malaria-free areas at sub-regional level and to support new initiatives wherever feasible. These guidelines on the elimination of malaria transmission foci provide information on identification of foci of malaria transmission, epidemiological classification, selection and application of appropriate measures and monitoring and evaluation of implemented interventions. The publication is targeted at policy and decision makers, malaria program managers at national and sub-national levels, and field staff. It can also be used in training courses on planning and management of malaria elimination
This report presents the findings of the first phase of the national Good Governance for Medicines programme in Jordan. In recent years, countries of the WHO Eastern Mediterranean Region have made significant achievements in the provision of health services. In the pharmaceutical field, countries have been striving to improve the structures and regulations pertaining to medicines and have progressed in many ways. However, there are still important challenges. The goal of the WHO Good Governance for Medicines programme is to improve the situation of medicines regulation and supply. National transparency assessment is the beginning of a process aimed at bringing about desirable and sustainable changes in the governance of the pharmaceutical sector.
WHO's concern is that, despite national and global efforts to control malaria, the disease burden remains high, especially in tropical Africa. The situation is further compounded in emergency situations. It is therefore necessary to review the current vector control strategies and their effectiveness in various operational and eco-epidemiological settings and to identify the challenges for implementation in different health systems. These would serve as a basis for the development of a strategic framework for strengthening malaria vector control implementation. The Roll Back Malaria (RBM) Initiative was launched by the WHO Director-General in 1998 as a Cabinet Project to coordinate global actions against malaria. The RBM goal is to reduce the global malaria burden by half by 2010 as compared to 2000"--Publisher's statement
Many countries have succeeded in eliminating malaria from their territories. However, they are still at risk of reintroduction from endemic countries and areas. The malaria programs in these countries face many challenges for prevention of malaria reintroduction, including weak malaria surveillance and vigilance systems, lack of malaria awareness among health professionals and travelers, uncontrolled population movement and lack of cooperation among countries. In the WHO Eastern Mediterranean Region 13 countries either eliminated malaria many years ago or are very close to malaria elimination. The main priority for these countries is to prevent re-establishment of local malaria transmission in receptive and vulnerable areas in their territories. These guidelines on prevention of reintroduction of malaria provide information on malaria surveillance and vigilance, malaria early warning system, prevention and control of re-introduced malaria, emergency preparedness for malaria outbreaks and monitoring, and evaluation of activities. The publication is targeted at policy and decision makers, health authorities responsible for malaria at national and sub-national levels and field staff. It can also be used in training courses on planning and management of malaria elimination.
The report identified policies and other relevant documents through an evidence review of peer-reviewed and grey literature supplemented by an enquiry of experts in health health literacy and policy in the Region and by health literacy policies included in the most recent peer-reviewed document on health literacy activities published in the Region (European Union (EU) countries only: HEALIT4EU). Further efforts to identify policies from countries of the Commonwealth of Independent States were unfruitful. Based on this evidence synthesis the following policy considerations are proposed: - consider the existing policies and related activities gathered in this review to develop or enhance health literacy policies and related activities to benefit citizens patients and communities; - broaden the range of areas of activity required for holistic health literacy policies to include the lived environment the workplace the media and digital/e-health at all societal levels ? individual community organization and system (legislative); - strengthen the evidence base for health literacy at all societal levels to ensure that policies address needs specific to the national or local context; -incorporate robust qualitative and quantitative evaluations into health literacy policies and interventions ? quantitative methods could include pre- and post-activity health literacy evaluations of evidence of health social and economic effects at all levels; and ?incorporate facilitators of successful implementation such as intersectoral working political leadership and strategies to overcome cultural barriers into health literacy policy. Member States would benefit from adopting such comprehensive frameworks and using metrics to design effective policies that support the development of a health-literate Europe.
Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others.
Target 5A of the United Nations Millennium Development Goals (MDGs) was to reduce maternal deaths by 75% between 1990 and 2015. The Maternal Mortality Estimation Inter-Agency Group comprising the World Health Organization (WHO) the United Nations Children?s Fund (UNICEF) the United Nations Population Fund (UNFPA) the World Bank Group and the United Nations Population Division assessed the 95 countries with an MMR higher than 100 in 1990. The report notes Cambodia the Lao People?s Democratic Republic and Mongolia have achieved this target in the Western Pacific Region. However maternal mortality remains higher than the Sustainable Development Goal (SDG) target in five countries in the Region. WHO has developed evidence-based maternal health recommendations for reducing maternal mortality and morbidity. This review compares national guidelines and protocols implementation and health system standards to WHO recommendations for eight countries that account for 96% of maternal deaths in the Western Pacific Region.
The purpose of this eighth meeting of the Expert Committee was: to analyse the global leprosy situation; to review the current status of developments in areas such as the treatment of leprosy and its various complications; to consider the results of research and experience in leprosy control since the previous meeting and to review existing indicators of progress in order to determine whether better indicators could be introduced; to advise on technical and operational issues relating to efforts aimed at further reducing the burden due to leprosy"--Introduction
The Regional Strategy and Plan of Action for Measles and Rubella Elimination in the Western Pacific was endorsed by the 68th session of the WHO Regional Committee in 2017. This document was developed in consultation with Member States and technical partners through carefully analysing the unsolved issues and emerging challenges that led to the regional resurgence of measles and outbreaks of rubella during 2013-2016. The document will guide development of national plans of action for achieving and sustaining measles and rubella elimination with country-specific strategies and activities that are tailored for addressing issues and challenges faced by each country and area of the region.
In order to reduce the impact of major risk factors such as unhealthy diet and physical inactivity, the World Health Assembly adopted the Global Strategy on Diet, Physical Activity and Health (DPAS) in May 2004 and the School Policy Framework on Diet and Physical Activity. DPAS is a call to Member States to develop and implement policies and programs that promote healthy diets and increase levels of physical activity. Subsequently, the World Health Organization (WHO) Regional Office for the Eastern Mediterranean developed a Regional Framework on Diet and Physical Activity for national policy-makers. The regional framework suggests several approaches to addressing issues of unhealthy diet and physical inactivity including in schools. This guide was reviewed by health-promoting school focal points from 16 countries in the Region and it includes their recommendations. It is a work in progress and is not intended to be prescriptive. Countries are encouraged to adapt the proposed interventions according to their own priority needs and social and cultural contexts and make use of mechanisms and tools already existing in country.
More than 99% of all human rabies deaths occur in the developing world and although effective and economical control measures are available the disease has not been brought under control throughout most of the affected countries. Given that a major factor in the low level of commitment to rabies control is a lack of accurate data on the true public health impact of the disease this report of a WHO Expert Consultation begins by providing new data on the estimated burden of the disease and its distribution in the world. It also reviews recent progress in the classification of rabies viruses rabies pathogenesis and diagnosis rabies pre- and post-exposure prophylaxis the management of rabies patients and canine as well as wildlife rabies prevention and control.
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