Tools and Guidelines

The update of the Guidelines for treatment of drug-susceptible tuberculosis and patient care is important in the context of the End TB Strategy, which recommends treatment and patient support for all people with TB. This update by WHO aims to use the best available evidence on the treatment of drug-susceptible TB and interventions to ensure adequate patient care and support in order to inform policy decisions made in these technical areas by national TB control programme managers, national policy-makers and medical practitioners in a variety of geographical, economic and social settings. The objectives of the updated Guidelines for treatment of drug-susceptible tuberculosis and patient care are: 1) to provide updated recommendations based on newly emerged evidence on the treatment of drug-susceptible TB and patient care; and 2) to provide a summary of changes in the new guidelines together with all the existing and valid WHO recommendations on the treatment of drug-susceptible TB and TB patient care.

The Republic of the Union of Myanmar’s National Strategic Plan on HIV/AIDS 2016–2020 is the strategic guide for the country’s response to HIV at national, state/regional and local levels. The framework describes the current dynamics of the HIV epidemic and articulates a strategy to optimize investments through a fast track approach with the vision of ending HIV as a public health threat by 2030. Myanmar’s third National Strategic Plan (HIV NSP III) issues a call to all partners to front-load investments to close the testing gap and reach the 90–90–90 prevention and treatment targets to protect health for all. This strategy builds upon Myanmar’s political commitment and the achievements of the previous HIV NSP II, and is aligned with the Three Ones principles and guides the country to focus on geographical, population and intervention priorities to ensure the greatest impact.

Adolescents are not simply old children or young adults. This deceptively simple observation lies at the heart of Global Accelerated Action for the Health of Adolescents (AA-HA!): Guidance to support country implementation, which reflects the coming of age of adolescent health within global public health. For years, the unique health issues associated with adolescence have been little understood or, in some cases, ignored. But that has now changed. Adolescent health and development was made an integral part of the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030) (The Global Strategy) because, in the words of the United Nations Secretary-General, “[adolescents are] central to everything we want to achieve, and to the overall success of the 2030 Agenda”. This Guidance is a milestone for translating the Global Strategy into action. It provides a wealth of information to policy-makers, practitioners, researchers, educators, donors, and civil society organizations – including the most up to-date data on the major disease and injury burdens that affect adolescents. It supports the implementation of the Global Strategy by providing the comprehensive information that countries need to decide what to do for adolescent health, and how to do it. It builds on on-going efforts to ensure that adolescents can Survive, Thrive and are in a position to Transform the societies in which they live.

A greater understanding of HIV in high prevalence countries has increased awareness of the need to prioritise adolescents in HIV prevention, treatment, care and support. At the same time, a growing recognition that adolescence is a distinct time of life has focused attention on adolescents’ different needs. Adolescents are now included as a separate target group in global and national strategies.  This Good Practice Guide was developed to offer programme managers and service providers concrete implementation guidance and support as they seek to address adolescents’ needs more effectively. It is intended to shape a provider’s approach and work so that adolescents living with HIV and those from key populations can obtain the services they need and live healthy, productive lives. The Good Practice Guide is shaped by the principles of the Positive Health, Dignity and Prevention Framework, with adolescents and young people at the centre, managing their own health and well-being.

The World Health Organization (WHO) estimates that childhood TB accounts for 6% to 10% of all TB cases worldwide each year. In countries with a high rate of TB disease, children account for as much as 40% of all new TB cases. In 2014, there were an estimated 3.1 million incident cases of TB in the SAARC Region, equivalent to 185 cases per 100000 populations and estimated deaths due to TB was 0.37 million. This carries 32% of the global burden of TB incidence. Four of the eight Member Countries in the Region are among the 22 high burden countries, with India accounting for 23 % of the world’s TB cases. Among 3.1 million incident TB cases, 2.1 million are notified new and relapse cases. Published data about the epidemiology of TB in children is scarce in SAARC Region, though it is considered one of the most common causes of childhood morbidity. The guideline focuses on being able to provide guidance in child TB to health workers working at the primary or secondary level.

According to Global TB Report 2015, worldwide, 9.6 million people are estimated to have fallen ill with TB in 2014: 5.4 million men, 3.2 million women and 1.0 million children. Globally, 12% of the 9.6 million new TB cases in 2014 were HIV-positive. It is estimated that accurate diagnosis and good reporting system children are likely to contribute 10-20% of disease burden in areas where the TB is poorly controlled. The incidence of paediatric TB provides an accurate measure of ongoing transmission within communities, which is a key indicator of control. Despite decline in death due to TB globally is still very high. In 2014, TB killed 1.5 million people (1.1 million HIV-negative and 0.4 million HIVpositive), making it one of the deadliest disease in the planet. The toll comprised 890,000 men, 480,000 women and 140,000 children.  A common misconception is that children are not severely affected by the TB epidemic and rarely develop severe forms of disease. This is not the case in TB endemic areas, where children are often present with advanced and serious disease (TB meningitis, Miliary TB).

Surveillance, when conducted ethically, is the foundation for programs to promote human well-being at the population level. It can contribute to reducing inequalities: pockets of suffering that are unfair, unjust and preventable cannot be addressed if they are not first made visible. But surveillance is not without risks for participants and sometimes poses ethical dilemmas. Issues about privacy, autonomy, equity, and the common good need to be considered and balanced, and knowing how to do so can be challenging in practice. The WHO Guidelines on Ethical Issues in Public Health Surveillance is the first international framework of its kind, it fills an important gap. The goal of the guideline development project was to to help policymakers and practitioners navigate the ethical issues presented by public health surveillance. This document outlines 17 ethical guidelines that can assist everyone involved in public health surveillance, including officials in government agencies, health workers, NGOs and the private sector.

Around the world, national health authorities and programmes are striving to ensure that “no one is left behind”, in keeping with this cross-cutting principle in the Sustainable Development Goals (SDGs). The Innov8 approach for reviewing national health programmes to leave no one behind (the Innov8 approach) aims to support these efforts. It also supports the progressive realization of universal health coverage and the right to health. As the partnering publication to the aforementioned Innov8 Technical Handbook, this Facilitator's Manual is meant for persons conducting the capacity-building workshops of Innov8 applications. Depending on the type of national and programmatic application, the World Health Organization (WHO) suggests that at least three capacity-building workshops be conducted for/with the national review team. One workshop is convened in each of the consecutive review process phases, which we describe here as sensitization, review and redesign.

The 2017 WHO Consolidated guidelines on person-centred HIV patient monitoring and case surveillance aim to help countries to implement WHO strategic information indicators for HIV (1) and WHO guidance on the use of antiretroviral drugs for HIV treatment (2) into routine HIV patient monitoring and health information systems.

In 2014, the World Health Organization (WHO) released the first edition of the Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis (EMTCT). In 2015, the Global Validation Advisory Committee for EMTCT was established and, as of October 2017, eleven countries or territories have been validated for achieving elimination of mother-to-child transmission (MTCT) of HIV and/or syphilis as a public health problem. This second edition of the EMTCT global validation guidance document captures the learning from these validation efforts to date, and reflects WHO’s commitment to the global effort to eliminate MTCT of HIV and syphilis, and expand the capacity of maternal and child health services to address vertical transmission of other communicable diseases. This second edition of the EMTCT global validation guidance document provides standardized processes and consensus-developed criteria to validate EMTCT of HIV and syphilis, and to recognize high-HIV burden countries that have made significant progress on the path to elimination. The guidance places strong emphasis on country-led accountability, rigorous analysis, intensive programme assessment and multilevel collaboration, including the involvement of communities of women living with HIV.