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GUY.01 Reducing the burden of disease: communicabl


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A message from Dr. Margaret Chan, Director General of the WHO



Urgent Annual Need for $1.6 Billion a Year in International Financing to Prevent Spread of Disease

The World Health Organization and the Global Fund to Fight AIDS, TB and Malaria said today that strains of tuberculosis with resistance to multiple drugs could spread widely and highlight an annual need of at least US$ 1.6 billion in international funding for treatment and prevention of the disease.

Dr Margaret Chan, Director General of the WHO, and Dr Mark Dybul, Executive Director of the Global Fund, said that the only way to carry out the urgent work of identifying all new cases of tuberculosis, while simultaneously making progress against the most serious existing cases, will be to mobilize significant funding from international donors.  

With the overwhelming majority of international funding for tuberculosis coming through the Global Fund, they said, it is imperative that efforts to raise money be effective this year. Growing alarm about the threat of multi-drug resistant TB, also known as MDR-TB, is making that even more pressing.

“We are treading water at a time when we desperately need to scale up our response to MDR-TB,” said Dr Chan. “We have gained a lot of ground in TB control through international collaboration, but it can easily be lost if we do not act now.”

The WHO and the Global Fund have identified an anticipated gap of US$1.6 billion in annual international support for the fight against tuberculosis in 118 low and middle income countries on top of an estimated US$3.2 billion that could be provided by the countries themselves. Filling this gap could enable full treatment for 17 million TB and multidrug-resistant TB patients and save 6 million lives between 2014-2016.

“It is critical that we raise the funding that is urgently needed to control this disease,” said Dr Dybul. “If we don’t act now, our costs could skyrocket. It is invest now or pay forever.”

Dr Chan and Dr Dybul spoke to the media in Geneva in advance of World TB Day on 24 March, which commemorates the day in 1882 when Dr Robert Koch discovered the mycobacterium that causes tuberculosis. 

While the Millennium Development Goal of turning around the TB epidemic has already been met, the 2 percent decline in the number of people falling ill with TB each year remains too slow.  Two regions – Africa and Europe -- are not on track to achieve the global target of halving the TB death rate between 1990 and 2015. In 2011, 1.4 million people died due to TB, with the greatest per capita death rate in Africa. Multidrug-resistant TB (MDR-TB) presents a major threat, with an estimated 630,000 people ill worldwide with this form of TB today.

WHO worked with the Global Fund and the Stop TB Partnership to support selected high TB burden countries in reviewing their priorities for the next three years and estimating available funding and gaps.  Estimates have been made for 118 countries eligible for Global Fund support.  Of the US$1.6 billion gap in donor financing, almost 60% is for WHO’s Africa region.

In the 118 countries, there are four priority areas for domestic and international investment to drive down deaths, alleviate suffering, cut transmission and contain spread of drug resistance:

·         For the core areas of expanded diagnosis and effective treatment for drug-susceptible TB (which will prevent MDR-TB), a total of US$2.6 billion is needed each year for the 2014-2016 period. For 2011, funding of about US$2 billion was available.  In low-income countries, especially in Africa, this is the largest area for increased financing.

·         Prompt and effective treatment for multidrug-resistant TB requires an estimated total of US$1.3 billion per year.  This is where the greatest increase in funding is needed in the coming years. For 2011, funding of US$0.5 billion was available.

·         Uptake of new rapid diagnostics and associated laboratory strengthening, especially for the diagnosis of MDR-TB and for TB diagnosis among people living with HIV, requires US$600 million per year.

·         Excluding antiretroviral treatment for TB patients living with HIV, which is financed by HIV programmes and their donors, about US$330 million is required for HIV-associated TB interventions, such as testing TB patients for HIV, ensuring regular screening for active TB disease among people living with HIV, and providing TB preventive treatment.

In addition to the US$1.6 billion annual gap in international financing for the critical implementation interventions above, WHO and partners estimate that there is a US$ 1.3 billion annual gap for TB research and development  during the period 2014-2016,  including clinical trials for new TB drugs, diagnostics and vaccines.



Last Updated on Monday, 25 March 2013 11:01

IMAI Training, 5-9 November 2012

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The Ministry of Health (MOH) in collaboration with the Pan American Health Organization (PAHO) conducted an IMAI workshop from 5 to9 November, 2012 at the Ocean View Hotel, Liliendaal as part of the scale up activity of the public health initiative which has had its genesis and adoption in Guyana since 2006 and which is a part of the broader effort to strengthen the integration of the HIV and chronic diseases services at primary health care level.

The opening session of the workshop was chaired by Dr. Rosalinda Hernandez Munoz, PAHO/WHO FCH/HIV Advisor whereas the welcome was done by Dr. Karen Cummings, the IMAI Coordinator, from the Ministry of Health (MOH) who not only applauded and thanked the financiers, the moral supporters and stakeholders like PAHO, MOH and Presidential Emergency Plan for AIDS Relief (PEPFAR), but appreciated the efforts made by the Regional Health Officers to put systems in place to facilitate this special IMAI training.    She welcomed the participants to a highly innovative, culturally relevant and mutually beneficial workshop.

Dr Beverley Barnett, the PAHO/WHO Representative in Guyana delivered the key message to the participants. She reiterated the need to decentralize and scale up HIV services and strengthen the Primary Health Care System (PHC). She posited that comprehensive and quality care should be given to Persons Living with HIV (PLWH) and efforts should be made to continue facilitating universal access to care, treatment and prevention of HIV by integrating clinical management of HIV/AIDS and Tuberculosis into the regular clinic schedules of the existing health services.

She encouraged the participants to embraced the integrated approach to chronic care as they strive to prepare, to inform and motivate  the health team, community partners and patients and their families about self-monitoring of key symptoms and treatments in addition to when to return for follow –up according to agreed plan. She challenged the healthcare workers to make full use of the training which entailed hard work so that they can apply knowledge learned for to recognize and provide the basic management of Opportunistic Infections and HIV related conditions.

The objectives of the workshop were:-
 1) To train  Health Workers from Region 2, 3, 4, 5 and 6 on the five Modules of IMAI strategy which were available for IMAI Training and implementation namely: - a) Acute Care, for adolescents and adults; b) Chronic HIV Care, with antiretroviral therapy (ART); c) General Principles of Good Chronic Care; d) Palliative Care, addressing symptom management and end of life care and e) TB/HIV Co- management;
 2) To prepare the care givers to provide Basic Anti retroviral treatment including Clinical Care and Acute Care at the primary care level and
 3) To guide the health professionals on communication skills in their management of patients who are HIV positive.

These objectives were carried out through lecture, breakout sessions, role playing, multimedia materials and question and answer sessions by facilitators from the Georgetown Public Hospital Corporation (GPHC), the National Tuberculosis Program (NTP) and the Davis’ Memorial Hospital.    The current Treatment guideline for Management of HIV-Infected and HIV-Exposed Adults and Children was presented by the National AIDS Program Secretariat (NAPS).

Topics varied from the Introduction to HIV/AIDS and opportunistic Infections, HIV and ARV Drugs, Adherence and Resistance, Prophylaxis to Communication and the Co- management of Tuberculosis (TB) and HIV.

The participants were happy for the training and promised to seek every opportunity to remain on the cutting edge of TB/HIV Co-Management. Their expectations were surpassed and they pledged as a next step to share the information with colleagues, to use the given tools, and to implement and integrate acquired best practices in day to day operations at their health locations in the various Regions.

Last Updated on Thursday, 20 December 2012 11:47

Enhance SARI Surveillance Training 29-30 September 2012

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Enhance SARI Surveillance Training

The Ministry of Health in collaboration with the Pan American Health Organization/World Health Organization (PAHO/WHO) conducted a two-day training on Enhance SARI Surveillance at Ocean View International Hotel from 29-30 September 2012.
The objectives of the training were:
1.    To train key stakeholder from GPHC in sample taking and SARI orientation.
2.    To strengthen Basic surveillance and Response Capacity to Influenza at GPHC
3.    To integrate the epidemiological and Laboratory surveillance of influenza into the System.

The training was facilitated by Dr. Dr Zoila Fletcher Payton, Consultant, Health Surveillance & Disease Prevention & Control, PAHO/WHO, Dr. Kamela Bemaul, Registrar, Georgetown Public Hospital Corporation and Mr. Javin Chandrabose, Head of Surveillance, Research and Emergency Preparedness Department, NPHRL.

Thirty-three (34) health workers from the GPHC participated in the training which included a combination of lecture and practical sessions such as sample demonstration and update from the NPHRL on SARI Surveillance, importance of hospital surveillance, overview of Novel Coronavirus and definition of ILI, SARI and confirmed cases of influenza.

The main output from the training was:
•    Weekly evaluation of samples sent from the GPHC Laboratory to the NPHRL, and feedback from the NPHRL to the GPHC doctors and nurses from the various wards that had sent the samples.

The training was well received by the participants. Some indicated that it was the first time they were exposed to training on SARI and Pandemic Influenza. Follow-up trainings will be conducted with participants of GPHC and private hospitals.



Last Updated on Tuesday, 08 January 2013 09:04

Guyana Observes World Mental Health Day, 10 October 2012

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World Mental Health Day 2012 Message From Dr. Beverley Barnett, PAHO/WHO Guyana Country Office Representative

Every year, World Mental Health Day, an initiative of the World Federation for Mental Health (WFMH) since 1992, is commemorated on 10 October.  World Mental Health Day is a global campaign inviting everyone –from global leaders to the public in all countries - to focus on a mental health challenge with global impact. It provides an opportunity for everyone to recognize the challenges that individuals, families, and communities experience due to mental disorders; discuss these disorders more openly; and support investments in prevention and treatment services.

The theme for World Mental Health Day 2012 is “Depression: A Global Crisis” and it aims to encourage governments and civil society around the world to address depression as a widespread illness that affects individuals, their families, their peers, and their communities, and to recognize that it is a treatable condition.  

Depression is a common mental disorder that presents with sad mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration. Moreover, depression often comes with symptoms of anxiety. These problems can become chronic or recurrent and lead to substantial impairments in an individual’s ability to take care of his or her everyday responsibilities. At its worst, depression can lead to suicide. Almost 1 million lives are lost yearly due to suicide, which translates to 3,000 suicide deaths every day. For every person who completes a suicide, 20 or more may attempt to end their lives (WHO, 2012). In Guyana, suicide prevention is a priority mental and public health issue.

Depression is a significant contributor to the global burden of disease and affects people in all communities across the world. Today, depression is estimated to affect 350 million people worldwide, and the World Mental Health Survey conducted in 17 countries found that on average about 1 in 20 people reported having an episode of depression in the previous year. Depressive disorders often start at a young age and the demand for curbing depression and other mental disorders is on the rise globally.  The global burden of depression poses a substantial public health challenge, both at the social and economic levels as well as the clinical level, and there are several well- defined, evidence- based strategies that can effectively reduce this burden.

Economic analyses have indicated that treating depression in primary care is feasible, affordable, and cost-effective. Many prevention programs implemented across the lifespan have provided evidence on the reduction of elevated levels of depressive symptoms. Effective community approaches to prevent depression focus on several actions surrounding the strengthening of protective factors and the reduction of risk factors. Examples of strengthening protective actors include school-based programs targeting children and adolescents, as well as exercise programs for the elderly. Interventions for parents of children with behavioral problems include provision of information and training in behavioral child-rearing strategies, which may reduce parental depressive symptoms and improve outcomes in the children, regarding their cognitive, problem-solving and social skills. Suicide prevention involves not only prevention and effective treatment of depression, but also restriction in access to means for suicide.

On this World Mental Health Day 2012, the Pan American Health Organization/World Health Organization (PAHO/WHO) emphasizes the importance of good mental health to prevent and alleviate pain and depression throughout the life-course in order to save lives, promote and protect health, and foster well-being. Regular physical activity, a healthy diet, relaxation techniques, healthy sleeping habits, and avoidance of stress, drug use, and the harmful use of alcohol, are all important in the maintenance of mental health.

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (WHO, 1948). Let us not neglect our mental health; let us educate ourselves about depression and other mental disorders, take measures to maintain our mental health, and support those who are suffering from mental disorders.


Last Updated on Tuesday, 09 October 2012 09:56

Guyana's modes of transmission study experience July 2012

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 An agreement was reached by the Ministry
of Health (MOH) and partners in Guyana that the
MOT exercise would begin with the establishment
of a technical working group (TWG) of data
experts (including individuals who actually had
hands-on experience working on previous surveillance
study data collection activities and
could respond to key questions posed during the
This TWG was responsible for conducting
the initial inventory of available data for this
study and included representatives from organisations
such as the MOH, National AIDS Programme
(NAP), Pan-American Health Organisation
(PAHO), Joint United Nations Programme
on HIV/AIDS (UNAIDS), United States Agency
for International Development (USAID), Centre
for Disease Control and Prevention (CDC), and
MEASURE Evaluation.

To read more please see PDF document below.

icon What do we know? (613.84 kB)

Last Updated on Tuesday, 09 October 2012 10:03
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