scholarly journals Global Governance of Anti-microbial Resistance: A Legal and Regulatory Toolkit

Author(s):  
Calvin W. L. Ho ◽  
Tsung-Ling Lee

Abstract Recognizing that antimicrobial resistance (AMR) poses a serious threat to global public health, the World Health Organization (WHO) has adopted a Global Action Plan (GAP) at the May 2015 World Health Assembly. Underscoring that systematic misuse and overuse of drugs in human medicine and food production is a global public health concern, the GAP-AMR urges concerted efforts across governments and private sectors, including pharmaceutical industry, medical professionals, agricultural industry, among others. The GAP has a threefold aim: (1) to ensure a continuous use of effective and safe medicines for treatment and prevention of infectious diseases; (2) to encourage a responsible use of medicines; and (3) to engage countries to develop their national actions on AMR in keeping with the recommendations. While the GAP is a necessary step to enable multilateral actions, it must be supported by effective governance in order to realize the proposed aims. This chapter has a threefold purpose: (1) To identify regulatory principles embedded in key WHO documents relating to AMR and the GAP-AMR; (2) To consider the legal and regulatory actions or interventions that countries could use to strengthen their regulatory lever for AMR containment; and (3) To highlight the crucial role of the regulatory lever in enabling other levers under a whole-of-system approach. Effective AMR containment requires a clearer understanding of how the regulatory lever could be implemented or enabled within health systems, as well as how it underscores and interacts with other levers within a whole-of-system approach.

2021 ◽  
pp. 19-23
Author(s):  
Donizete Tavares Da Silva ◽  
Priscila De Sousa Barros Lima ◽  
Renato Sampaio Mello Neto ◽  
Gustavo Magalhães Valente ◽  
Débora Dias Cabral ◽  
...  

In March 2020, the World Health Organization (1) declared COVID-19 as a pandemic and a threat to global public health (2). The virus mainly affects the lungs and can cause acute respiratory distress syndrome (ARDS). In addition, coronavirus 2 severe acute respiratory syndrome (SARSCOV2) also has devastating effects on other important organs, including the circulatory system, brain, gastrointestinal tract, kidneys and liver


2014 ◽  
Vol 27 (3) ◽  
pp. 511-529 ◽  
Author(s):  
Sudeepa Abeysinghe

ArgumentScientific uncertainty is fundamental to the management of contemporary global risks. In 2009, the World Health Organization (WHO) declared the start of the H1N1 Influenza Pandemic. This declaration signified the risk posed by the spread of the H1N1 virus, and in turn precipitated a range of actions by global public health actors. This article analyzes the WHO's public representation of risk and examines the centrality of scientific uncertainty in the case of H1N1. It argues that the WHO's risk narrative reflected the context of scientific uncertainty in which it was working. The WHO argued that it was attempting to remain faithful to the scientific evidence, and the uncertain nature of the threat. However, as a result, the WHO's public risk narrative was neither consistent nor socially robust, leading to the eventual contestation of the WHO's position by other global public health actors, most notably the Council of Europe. This illustrates both the significance of scientific uncertainty in the investigation of risk, and the difficulty for risk managing institutions in effectively acting in the face of this uncertainty.


2020 ◽  

In the past 100 years, the world has faced four distinctly different pandemics: the Spanish flu of 1918-1919, the SARS pandemic of 2003, the H1N1 or “swine flu” pandemic of 2012, and the ongoing COVID-19 pandemic. Each public health crisis exposed specific systemic shortfalls and provided public health lessons for future events. The Spanish flu revealed a nursing shortage and led to a great appreciation of nursing as a profession. SARS showed the importance of having frontline clinicians be able to work with regulators and those producing guidelines. H1N1 raised questions about the nature of a global organization such as the World Health Organization in terms of the benefits and potential disadvantages of leading the fight against a long-term global public health threat. In the era of COVID-19, it seems apparent that we are learning about both the blessing and curse of social media.


2020 ◽  
Vol 19 (3) ◽  
Author(s):  
A Hirschmann ◽  
T Pillay ◽  
KW Fang ◽  
MT Ramokgopa ◽  
C Frey

ABSTRACT BACKGROUND: On 11 March 2020 the World Health Organization (WHO) declared COVID-19 a worldwide pandemic and a threat to global public health. In this paper we aim to describe the measures implemented to combat the COVID-19 pandemic in the Department of Orthopaedic Surgery at Chris Hani Baragwanath Academic Hospital (CHBAH), Soweto, Johannesburg, the largest hospital in Africa with approximately 3 200 beds and about 6 760 staff members. At the time of writing this report, we have transitioned from level 5 to level 3 lockdown METHODS: We performed a literature review and drew on the experiences of previous pandemic response plans worldwide. A working group comprising all relevant disciplines was created to develop standard operating procedures in line with governmental policy RESULTS: We found that by developing a multi-phase plan, we were able to maintain service delivery to all emergent patients while protecting medical staff and patients alike. This plan also allowed coordination with other disciplines and made provision for staff from within the Department of Orthopaedic Surgery to be made available to work within other departments as and when required. The implementation of this plan had to evolve constantly, adjusting to the changes in the national lockdown level and the demands of the developing situation CONCLUSION: We hope that by sharing our plan with our colleagues domestically and abroad, we can promote discussion and improve our ability to better prepare and deal with this unprecedented healthcare scenario. In order for us to win as individuals, we must fight as a team Level of evidence: Level 5 Keywords: COVID-19, orthopaedics, plan, response, Baragwanath


2020 ◽  
Vol 17 (1) ◽  
pp. 261-290 ◽  
Author(s):  
Steven A. Solomon ◽  
Claudia Nannini

Participation in the World Health Organization (WHO) is a multifaceted matter and should be understood as not only referring to the governance of WHO, but also to its scientific and technical work as well as its collaborative efforts towards advancing global public health more generally. The article is concerned, in particular, with the legal and political framework surrounding attendance and participation of states and various entities in the governing bodies of the Organization, at the global and regional level. It shows that participation in the governance of WHO is still today a domain reserved to the determination of its Member States. At the same time, solutions have been found and continued efforts are necessary to take into account geopolitical considerations and to ensure a meaningful and inclusive participation of all relevant actors in global health discussions.


2014 ◽  
Vol 6 (1) ◽  
pp. e2014070 ◽  
Author(s):  
Giorgia Sulis ◽  
Alberto Roggi ◽  
Alberto Matteelli ◽  
Mario C. Raviglione

Tuberculosis (TB) is a major public health concern worldwide: despite a regular, although slow, decline in incidence over the last decade, as many as 8.6 million new cases and 1.3 million deaths were estimated to have occurred in 2012. TB is by all means a poverty-related disease, mainly affecting the most vulnerable populations in the poorest countries. The presence of multidrug-resistant strains of M. tuberculosis in most countries, with some where prevalence is high, is among the major challenges for TB control, which may hinder recent achievements especially in some settings. Early TB case detection especially in resource-constrained settings and in marginalized groups remains a challenge, and about 3 million people are estimated to remain undiagnosed or not notified and untreated. The World Health Organization (WHO) has recently launched the new global TB strategy for the “post-2015 era” aimed at “ending the global TB epidemic” by 2035, based on the three pillars that emphasize patient-centred TB care and prevention, bold policies and supportive systems, and intensified research and innovation.This paper aims to provide an overview of the global TB epidemiology as well as of the main challenges that must be faced to eliminate the disease as a public health problem everywhere.


2018 ◽  
Vol 29 (9) ◽  
pp. 873-883 ◽  
Author(s):  
Reuben Granich ◽  
Somya Gupta

The human immunodeficiency virus (HIV) and Mycobacterium tuberculosis syndemic remains a global public health threat. Separate HIV and tuberculosis (TB) global targets have been set; however, success will depend on achieving combined disease control objectives and care continua. The objective of this study was to review available policy, budgets, and data to reconceptualize TB and HIV disease control objectives by combining HIV and TB care continua. For 22 World Health Organization (WHO) TB and TB/HIV priority countries, we used 2015 data from the HIV90–90–90watch website, UNAIDS AIDSinfo, and WHO 2016 and 2017 Global TB Reports. Global resources available in TB and HIV/TB activities for 2003–2017 were collected from publicly available sources. In 22 high-burden countries, people living with HIV on antiretroviral therapy ranged from 9 to 70%; viral suppression was 38–63%. TB treatment success ranged from 71 to 94% with 14 (81% HIV/TB burden) countries above 80% TB treatment success. From 2003 to 2017, reported global international and domestic resources for HIV-associated TB and TB averaged $2.85 billion per year; the total for 2003–2017 was 43 billion dollars. Reviewing combined HIV and TB targets demonstrate disease control progress and challenges. Using an integrated HIV and TB continuum supports HIV and TB disease control efforts focused on improving both individual and public health.


2019 ◽  
Vol 5 (3) ◽  
pp. eaau9124 ◽  
Author(s):  
Katariina M. M. Pärnänen ◽  
Carlos Narciso-da-Rocha ◽  
David Kneis ◽  
Thomas U. Berendonk ◽  
Damiano Cacace ◽  
...  

Integrated antibiotic resistance (AR) surveillance is one of the objectives of the World Health Organization global action plan on antimicrobial resistance. Urban wastewater treatment plants (UWTPs) are among the most important receptors and sources of environmental AR. On the basis of the consistent observation of an increasing north-to-south clinical AR prevalence in Europe, this study compared the influent and final effluent of 12 UWTPs located in seven countries (Portugal, Spain, Ireland, Cyprus, Germany, Finland, and Norway). Using highly parallel quantitative polymerase chain reaction, we analyzed 229 resistance genes and 25 mobile genetic elements. This first trans-Europe surveillance showed that UWTP AR profiles mirror the AR gradient observed in clinics. Antibiotic use, environmental temperature, and UWTP size were important factors related with resistance persistence and spread in the environment. These results highlight the need to implement regular surveillance and control measures, which may need to be appropriate for the geographic regions.


Author(s):  
Jeff Clyde G Corpuz

Abstract The current public health crisis has radically altered the social and civic involvement in Southeast Asia. Although the virus has shifted the landscape of engagement, it has not dampened the enthusiasm of the public. In 2020–2021, more people than ever seem to be paying attention and even getting involved in activism. Many dramatic events happened during the coronavirus crisis such as from protests in support of the Black Lives Matter movement, public activism around the environment, economic inequality, authoritarianism and human rights violations. In Indonesia, the Philippines, Malaysia, Thailand and just recently Myanmar. The journal has lately published about the ‘Relationship of George Floyd protests to increases in COVID-19 cases using event study methodology’ and it has rightly expressed that the Centers for Disease Control and Prevention (CDC)-recommended social distancing guidelines must be followed in a protest situation. In response to the situation of social activism in Southeast Asia, one must follow the CDC-recommended and World Health Organization (WHO) guidelines in the Region. Although protesting is an individual human right, one must also be cautious and be aware of the deadly virus since we are still in a pandemic and the COVID-19 virus continues to mutate.


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