Bulletin of the World Health Organization最新文献

Substantial scientific and regulatory challenges must be overcome to support the safe and effective integration of traditional medicines into health systems. Gary Humphreys reports.

Traditional knowledge on health has long contributed to global health-care systems. Rooted in the cultural and ecological heritage of Indigenous Peoples and local communities, traditional knowledge has influenced pharmaceutical research, biodiversity conservation and public health strategies. However, concerns over misappropriation of traditional knowledge and inadequate benefit-sharing with the sources of such knowledge persist. The World Intellectual Property Organization Treaty on Intellectual Property, Genetic Resources and Associated Traditional Knowledge mandates patent disclosure requirements for genetic resources and traditional knowledge. While a step forward, the treaty's success depends on its effective implementation, ethical documentation of traditional knowledge, governance of artificial intelligence and equitable benefit-sharing mechanisms, among other factors. We examine traditional knowledge protection under intellectual property systems, the provisions of the World Intellectual Property Organization treaty, challenges to documentation of traditional knowledge and the role of artificial intelligence in the governance of traditional knowledge. By fostering a legally robust and technology-driven protection system for traditional knowledge, policy-makers can ensure that traditional knowledge remains both a protected cultural heritage and a resource for sustainable innovation in global health.

Objective: To explore the effect of anticipatory action on outcomes during a cholera outbreak in a hypothetical health zone in the Democratic Republic of the Congo by means of a cholera response model.

Methods: Using a system dynamics approach, we developed a cholera response model for the Democratic Republic of the Congo on the basis of a published cholera response simulation model for Yemen. The model evaluated four intervention scenarios: (i) existing responses to cholera outbreaks; (ii) anticipatory action (that is, immediate interventions); (iii) anticipatory action plus one vaccine dose; and (iv) anticipatory action plus two vaccine doses.

Findings: The model showed that immediate interventions can function as an essential bridge to comprehensive vaccination, particularly in resource-constrained settings where timely coordination is crucial. Moreover, anticipatory action can reduce the total number of cholera cases. However, booster vaccinations are crucial for preventing subsequent waves of infection due to waning immunity following single-dose vaccination.

Conclusion: Anticipatory action can enhance cholera outbreak management in low-resource settings by facilitating synergy between immediate and long-term interventions. The timing and coordination of interventions and the use of booster doses to prevent disease resurgence are all important. Dynamic models are useful for simulating outbreaks and can foster proactive, evidence-based public health planning, thereby supporting the shift from reactive to anticipatory strategies in alignment with the Global Task Force on Cholera Control's 2030 cholera roadmap. Continuous refinement of the model with real-world data will enhance its global applicability and help advance effective disease control strategies.

Objective: To investigate associations between digital maturity in health and primary health care performance globally.

Methods: We conducted a search of publicly available data on digital maturity in health and primary health care performance for the 194 World Health Organization Member States. We identified 14 indicators of digital maturity in health, covering seven core subcomponents. A digital maturity in health index was derived from these indicators. Primary health care performance was assessed using the universal health coverage effective coverage index.

Findings: Digital maturity in health data were missing for 85 of the 194 countries, with considerable variation across subcomponents. The remaining 109 countries were divided into four types by digital maturity in health index. We identified countries leading or lagging in digital maturity and highlighted the strongest and weakest subcomponents. Overall, there was a strong, nonlinear, positive correlation between digital maturity in health and primary health care performance (Spearman correlation: 0.85). However, there were notable exceptions, which indicates digital maturity can enhance primary health care but is not necessary for its improvement. The relationship between health-care expenditure and digital maturity in health and primary health care performance varied among countries with similar spending and digital maturity.

Conclusion: Overall, primary health care performance was positively associated with digital maturity in health and health-care expenditure. However, some countries had a strong primary health care system despite low digital maturity, and some had high digital maturity but a weak primary health care system. The study's findings could help policy-makers prioritize investment in digital health.

Objective: To determine how Escherichia coli contamination of household water affects the probability of stunting and underweight in children younger than 5 years in 29 low- and middle-income countries and territories.

Methods: We used data describing health, nutrition, education, and water, sanitation and hygiene (i.e. E. coli testing) from the global Multiple Indicator Cluster Surveys. We conducted multiple linear regression analyses to estimate the effects of E. coli contamination on the growth outcomes of stunting and underweight in children, and to explore the underlying mechanisms. We also conducted subgroup analyses to examine heterogeneous effects at both the macro- and microlevels.

Findings: Three quarters of the children in our pooled sample (26 498/35 012) were living in households with drinking water contaminated with E. coli. We observed that these children had a 2.3 (95% confidence interval, CI: 0.006 to 0.039) and 1.8 (95% CI: 0.006 to 0.031) percentage point higher probability of experiencing stunting and underweight, respectively, than children living in households with uncontaminated water. Our heterogeneity analyses revealed significant effects of E. coli contamination in girls and in poorer households (microlevel); in low- and lower-middle-income countries and territories; and in the World Health Organization African Region and Region of the Americas (macrolevel). Finally, we identified diarrhoea as a potential mechanism through which E. coli contamination might adversely affect child growth.

Conclusion: Our findings highlight the critical need to eliminate E. coli contamination from household water sources to improve both child health and growth outcomes; changing behaviours related to open defecation remains a key strategy.