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The first version of the World Health Organization Model list of essential medicines contained 186 medicines in 1977 and has evolved to include 502 medicines in 2023. Over time, different articles criticized the methods and process for decisions; however, the list holds global relevance as a model list to over 150 national lists. Given the global use of the model list, reflecting on its future role is imperative to understand how the list should evolve and respond to the needs of Member States. In 2023, the model list Expert Committee recommended the World Health Organization (WHO) to initiate a process to revise the procedures for updating the model list and the criteria guiding decisions. Here, we offer an agenda outlining priority areas and a vision for an authoritative model list. The main areas include improving transparency and trustworthiness of the recommendations; strengthening connection to national lists; and continuing the debate on the principles that should guide the model list, in particular the role of cost and price of essential medicines. These reflections are intended to support efforts ensuring the continued impact of this policy tool. [phrase omitted] La premiere version de la Liste modele des medicaments essentiels de l'OMS, publiee par l'Organisation mondiale de la Sante, repertoriait 186 medicaments en 1977 et s'est enrichie jusqu'a en inclure 502 en 2023. Au fil du temps, differents articles ont critique ses methodes et processus decisionnels; toutefois, elle reste importante au niveau mondial, servant de reference a plus de 150 listes nationales. Compte tenu de l'usage international qui en est fait, il est imperatif de reflechir a sa fonction future afin de comprendre comment elle peut evoluer et repondre aux besoins des Etats Membres. En 2023, le Comite d'experts charge de la liste modele a recommande a l'OMS de se lancer dans la revision des procedures de mise a jour de cette liste, ainsi que des criteres appliques aux decisions. Dans le present document, nous proposons un programme qui definit les priorites et les perspectives d'avenir pour que la liste fasse autorite. Parmi les principaux domaines abordes figurent l'amelioration de la transparence et de la fiabilite des recommandations, le renforcement des liens avec les listes nationales et la poursuite du debat sur les principes qui devraient orienter la liste modele, en particulier le role joue par les couts et les prix des medicaments essentiels. Ces reflexions ont pour but de soutenir les efforts permettant a cet instrument politique de conserver son impact. [phrase omitted] La primera version de la Lista Modelo OMS de Medicamentos Esenciales contenia 186 medicamentos en 1977 y ha evolucionado hasta incluir 502 medicamentos en 2023. Con el tiempo, diferentes articulos criticaron los metodos y el proceso de decision; sin embargo, la lista conserva su relevancia mundial como lista modelo para mas de 150 listas nacionales. Dado el uso global de la lista modelo, es imperativo reflexionar sobre su funcion futura para comprender como debe evolucionar la lista y responder a las necesidades de los Estados Miembros. En 2023, el Comite de Expertos de la lista modelo recomendo a la OMS que iniciara un proceso para revisar los procedimientos de actualizacion de la lista modelo y los criterios que guian las decisiones. En este documento, se ofrece un programa en el que se describen las areas prioritarias y la vision de una lista modelo oficial. Entre las principales areas se incluyen la mejora de la transparencia y la fiabilidad de las recomendaciones, el refuerzo de la conexion con las listas nacionales y la continuacion del debate sobre los principios que deben guiar la lista modelo, en particular sobre la funcion del coste y el precio de los medicamentos esenciales. El objetivo de estas reflexiones es apoyar los esfuerzos que aseguren el impacto continuado de esta herramienta politica., Introduction The World Health Organization model list of essential medicines is almost 50 years old. The model list is a normative product of the World Health Organization (WHO), aimed at [...]

BackgroundMost of the disability-related scholarly literature focuses on high-income countries, whereas there is a lack of data concerning challenges (barriers and obstacles) and opportunities (participatory research and community engagement) in the Global South. Moreover, many frameworks for interventions for people with disabilities (PWDs) have been designed for resource-rich contexts, and little is known about their translatability to low- and middle-income countries (LMICs).ObjectiveThe main objective of this study was to design and pilot an interventional approach based on an innovative framework aimed at improving the livelihood of PWDs in LMICs.MethodologyThe present mixed-method study was conducted in Bamenda, North-West Region of Cameroon, through an intervention of household visits by community health workers using innovation and best practices informed by a systematic literature review and embedded into an evidence toolkit called the eBASE Family-Centered Evidence Toolkit for Disabilities (EFCETD), adapted from the WHO matrix and consisting of 43 questions across five categories (health, education, social wellbeing, empowerment, and livelihood). Out of 56 PWDs identified, 30 were randomly sampled, with an attrition of four participants. Three datasets (baseline, qualitative, and quantitative) were collected. The Washington Group tool, exploring the type of disability, gender, how long one has had the disability, their facility situation coupled with their coping strategies, and the context of livelihood, was used to design the questionnaire for baseline data collection. Qualitative data were collected through key informant interviews and focus group discussions analyzed with MAXQDA, while quantitative data were collected through the EFCETD and analyzed by means of descriptive statistics.ResultsIn total, 69.2% of PWDs were female individuals. Many PWDs were aged 10–20 years (57% of the sample size). Physical/motor disability was the most common type of disability recorded (84.6%). The mean percentile for education increased from 29.9% during the first visit to 70.2% during the last visit, while the mean percentile for health increased from 65.4 to 78.7% and the mean percentile for social wellbeing moved from 73.1 to 84.9%. The livelihood and empowerment standards increased from 16.3 to 37.2% and from 27.7 to 65.8%, respectively. Overall, the temporal trend was statistically significant (F = 35.11, p

BackgroundThe COVID-19 pandemic has already claimed considerable lives. There are major concerns in Africa due to existing high prevalence rates for both infectious and non-infectious diseases and limited resources in terms of personnel, beds and equipment. Alongside this, concerns that lockdown and other measures will have on prevention and management of other infectious diseases and non-communicable diseases (NCDs). NCDs are an increasing issue with rising morbidity and mortality rates. The World Health Organization (WHO) warns that a lack of nets and treatment could result in up to 18 million additional cases of malaria and up to 30,000 additional deaths in sub-Saharan Africa.ObjectiveDocument current prevalence and mortality rates from COVID-19 alongside economic and other measures to reduce its spread and impact across Africa. In addition, suggested ways forward among all key stakeholder groups.Our ApproachContextualise the findings from a wide range of publications including internet-based publications coupled with input from senior-level personnel.Ongoing ActivitiesPrevalence and mortality rates are currently lower in Africa than among several Western countries and the USA. This could be due to a number of factors including early instigation of lockdown and border closures, the younger age of the population, lack of robust reporting systems and as yet unidentified genetic and other factors. Innovation is accelerating to address concerns with available equipment. There are ongoing steps to address the level of misinformation and its consequences including fines. There are also ongoing initiatives across Africa to start addressing the unintended consequences of COVID-19 activities including lockdown measures and their impact on NCDs including the likely rise in mental health disorders, exacerbated by increasing stigma associated with COVID-19. Strategies include extending prescription lengths, telemedicine and encouraging vaccination. However, these need to be accelerated to prevent increased morbidity and mortality.ConclusionThere are multiple activities across Africa to reduce the spread of COVID-19 and address misinformation, which can have catastrophic consequences, assisted by the WHO and others, which appear to be working in a number of countries. Research is ongoing to clarify the unintended consequences given ongoing concerns to guide future activities. Countries are learning from each other.

Background: Multiple measures introduced early to restrict COVID-19 have dramatically impacted the teaching of medical and pharmacy students, exacerbated by the lack of infrastructure and experience with e-learning at the start of the pandemic. In addition, the costs and reliability of the Internet across Africa pose challenges alongside undertaking clinical teaching and practical programmes. Consequently, there is a need to understand the many challenges and how these were addressed, given increasingly complex patients, to provide future direction. Method: An exploratory study was conducted among senior-level medical and pharmacy educators across Africa, addressing four key questions, including the challenges resulting from the pandemic and how these were dealt with. Results: Staff and student members faced multiple challenges initially, including adapting to online learning. In addition, concerns with the lack of equipment (especially among disadvantaged students), the costs of Internet bundles, and how to conduct practicals and clinical teaching. Multiple activities were undertaken to address these challenges. These included training sessions, developing innovative approaches to teaching, and seeking ways to reduce Internet costs. Robust approaches to practicals, clinical teaching, and assessments have been developed. Conclusions: Appreciable difficulties to teaching arising from the pandemic are being addressed across Africa. Research is ongoing to improve education and assessments.

Disability is very common and yet not well understood within sub-Saharan African countries. There has been growing attention to the use of research evidence to improve social inclusion of persons living with disabilities. This article reports on a process that can be used to monitor and evaluate evidence databases to encourage improvements in website and content accessibility for people with disabilities. We examined five evidence communities' online databases by: (1) assessing the accessibility of these website databases; and (2) assessing the resources within these websites. Finally, we aimed to provide feedback from the evaluation to these evidence databases. We carried out a cross-sectional study of the online evidence databases using the Web Content Accessibility Guidelines - a universal standard for web content accessibility assessment. We assessed access to the databases using a purposive sample of 25 resources within them. Resources are meant to improve practice, policy and decision making for all, including people with disabilities. They include systematic reviews, reports and articles. Accessibility is being able to obtain, understand and use resources; addressing barriers that could hinder this is important. Even though these evidence databases are considered as enabling inclusion and diversity within the evidence ecosystem, their contents are not fully accessible to people with disabilities, and they only partially met the recommendations of the Web Content Accessibility Guidelines. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives: Good‐quality clinical practice guidelines (CPGs) provide recommendations based on current best‐evidence summaries. Hypertension is a prevalent noncommunicable disease in Africa, with disastrous sequelae (stroke, heart, and kidney disease). Its effective management relies on good quality, current, locally relevant evidence. This paper reports on an all African review of the guidance documents currently informing hypertension management. Methods: Attempts were made to contact 62 African countries for formal guidance documents used nationally to inform diagnosis and management of hypertension. Their quality was assessed by using Appraisal of Guidelines for Research & Evaluation (AGREE) II, scored by 2 independent reviewers. Differences in domain scores were compared between documents written prior to 2011 and 2011 onward. Findings were compared with earlier African CPG reviews. Results: Guidelines and protocols were provided by 26 countries. Six used country‐specific stand‐alone hypertension guidelines, and 10 used protocols embedded in Standard Treatment Guidelines for multiple conditions. Six used guidelines developed by the World Health Organization, and 4 indicated ad hoc use of international guidance (US, Portugal, and Brazil). Only 1 guidance document met CPG construction criteria, and none scored well on all AGREE domain scores. The lowest‐scoring domain was rigour of development. There was no significant quality difference between pre‐2011 and post‐2011 guidance documents, and there were variable AGREE II scores for the same CPGs when comparing the African reviews. Conclusions: The quality of hypertension guidance used by African nations could be improved. The need for so many guidance documents is questioned. Adopting a common evidence base from international good‐quality CPGs and layering it with local contexts offer 1 way to efficiently improve African hypertension CPG quality and implementation. [ABSTRACT FROM AUTHOR]