Tools and Guidelines

In 2016, WHO published updated consolidated guidelines on the use of antiretroviral (ARV) drugs for treating and preventing HIV infection. These guidelines included recommendations on the choice of ARV drugs for first- and second-line antiretroviral therapy (ART). An efavirenz (EFV 600 mg)-based regimen was recommended as the preferred first-line regimen, with a dolutegravir (DTG)- or efavirenz (400 mg)-based regimen recommended as alternative options because of limited efficacy and safety data in pregnancy and when taken concomitantly with tuberculosis (TB) treatment. ART recommendations for children remained unchanged in 2016 compared with 2013 because of lack of approved DTG dosing for use in children.

This updated implementation guidance is intended for all those who set policy for, or offer care to, pregnant women, families and infants: governments; national managers of maternal and child health programmes in general, and of breastfeeding- and Baby-friendly Hospital Initiative (BFHI)-related programmes in particular; and health-facility managers at different levels (facility directors, medical directors, chiefs of maternity and neonatal wards). The document presents the first revision of the Ten Steps since 1989. The topic of each step is unchanged, but the wording of each one has been updated in line with the evidence-based guidelines and global public health policy.

This toolkit was developed to help program implementers, particularly community-based organizations (CBOs) and others working in direct service delivery, to more effectively address safety and security challenges within their implementation of HIV programs for and with key populations. It is designed for use in hostile environments; for example, where members of key populations are criminalized and face elevated levels of stigma, discrimination, and violence. The toolkit has three section: first is a review of safety and security challenges and their impact on HIV programming, and promising practices and recommendations to address these challenges.  Secondly, three practical checklists help programme implementers systematically identify strengths and weaknesses in their efforts to protect organisations, individuals, and implementation sites. Last is an annotated bibliography of safety and security resources.

The emergence of drug-resistant TB is a major global health concern, which threatens the ambitious goals and progress set under the End TB Strategy. Isoniazid-resistant TB, which is present in 8% of TB cases worldwide, reduces treatment success in patients treated with the standard 6-month first-line regimen.

These new guidelines supersede previous WHO policy documents on the management of Latent TB Infection (LTBI) in people living with HIV, household contacts of people with active TB, other groups at risk of developing TB, and for LTBI testing. The consolidated guidelines are expected to provide the basis and rationale for the development of national guidelines for LTBI management, adapted to the national and local epidemiology of TB, the availability of resources, the health infrastructure and other national and local determinants. 

These guidelines provide recommendations and good practice guidance on the optimal approach to diagnosing cryptococcal meningitis, strategies for preventing invasive cryptococcal disease through cryptococcal antigen screening and pre-emptive fluconazole therapy, treating cryptococcal meningitis with combination antifungal therapy regimens, preventing, monitoring and managing amphotericin B drug toxicity, recommendations against adjunctive therapy with systemic corticosteroids and recommendations on the timing of antiretroviral therapy (ART) initiation.

Each year we commemorate World TB Day on March 24 to raise public awareness about the devastating health, social and economic impact of tuberculosis (TB) and urge acceleration of efforts to end the global TB epidemic. The aim of this campaign, starting on 19 March, the week of the World TB Day date, is to build overarching commitment and leadership at the highest level to End TB. Despite significant progress over the last decades, TB continues to be the top infectious killer worldwide, claiming over 4500 lives a day. The emergence of drug-resistant TB (DR-TB) poses a major health threat and could put at risk gains made in efforts to end TB.

This guide considers the many ways in which gender and HIV interact, and how this is influenced by variables such as education, income, age, ethnicity, race, disability, migrant status, health, location, and sexual orientation.   It contains tools, evidence and good practice to ensure that HIV programming responds to and addresses harmful gender norms, structures and stereotypes that act as a barrier to HIV prevention, treatment and care, and the realisation of sexual and reproductive health and rights.

This technical update provides public health officials with guidance on applying HIV incidence assays and testing algorithms for recent HIV infection in order to monitor the HIV epidemic and assess the impact of interventions. A major theme of this update is the importance of calibrating two of the key performance characteristics of recent testing infections algorithms - mean duration of recent infection and false recent ratio - to account for the context in which the testing is being done. This technical update also describes several emerging use cases in the application of recent infection testing algorithms and tests, including those for individual-level use. A final section on further research directions is provided to highlight areas that still require investigation.

This guideline is a consolidated set of new and existing recommendations on essential labour and childbirth practices that should be provided to all pregnant women and their babies during labour and childbirth irrespective of socioeconomic setting. It promotes the delivery of a package of labour and childbirth interventions that is critical to ensuring that giving birth is not only safe but also a positive experience for women and their families. It highlights how woman-centred care can optimize the quality of labour and childbirth care through a holistic, human rights-based approach. By outlining a new model of intrapartum care that is adaptable to individual country contexts, the guideline enables substantial cost-savings through reduction in unnecessary interventions during labour and childbirth.