The WHO Regional Office for the Eastern Mediterranean is the regional office of the World Health Organization that serves 22 countries and territories in the Middle East, the North Africa, the Horn of Africa and Central Asia. It is one of the WHO's six regional offices around the world..
Background:National reference laboratories are central to antimicrobial resistance surveillance, yet their capacities vary widely across the Eastern Mediterranean Region. Aim:To assess the readiness of national reference laboratories in the Eastern Mediterranean Region for antimicrobial resistance surveillance. Methods:From November 2019 to June 2020 and from December 2024 to February 2025 we collected and analysed data relating to antimicrobial resistance surveillance capacities of national reference laboratories from the 22 countries and territories in the WHO Eastern Mediterranean Region. We compared the paired binary indicators using the 2-sided exact McNemar test (P < 0.05) and analysed the secondary Global Antimicrobial Resistance and Use Surveillance System data for 2017-2023. Results:Only 3 national reference laboratories had the full public health capacity. Limited confirmatory and reference testing, poor data integration and use, shortage of skilled workforce, and suboptimal quality assurance mechanisms were the major gaps identified. Fungal diagnostic capacity was a critical and largely neglected gap. There were no statistically significant within-country changes among the 9 countries included in the longitudinal comparison. The Global Antimicrobial Resistance and Use Surveillance System data suggest gradual strengthening of surveillance infrastructure. Conclusion:There is an urgent need to strengthen the core functions of national reference laboratories in the Eastern Mediterranean Region to better support antimicrobial surveillance systems.
Background In April 2019, an outbreak of HIV was reported in Larkana district of Sindh province, Pakistan. The outbreak primarily affected children and was associated with unsafe injections in healthcare settings. Testing services delivered from health care facilities continued to identify new HIV infections in Larkana and surrounding districts. We describe a community-based educate, test and treat initiative implemented in these areas to identify undiagnosed HIV infections in the community. We analyzed the data to describe HIV-positivity, linkage to care and HIV risk exposure among diagnosed persons. Methods HIV rapid testing was offered door-to-door to people 18 months to 60 years of age who were not known to be HIV-positive. Testing was conducted in 12 union councils (UCs; lowest administrative unit) of Taluka/sub-district “Ratodero” (district Larkana), four UCs of Taluka “Garhi Yasin” (district Shikarpur) and seven UCs of Taluka “Garhi Khairo” (district Jacobabad). Those with two reactive rapid results in the community were referred for confirmation and linkage to care at the nearest HIV treatment centre. We calculated HIV positivity (number of people with two reactive rapid tests in the community among those tested) disaggregated by age, sex and location, and assessed the proportion linked to care among those HIV-positive and self-reported HIV risk exposure among those diagnosed. Findings Between 6 and 21 September 2023, 43,883 individuals were tested in Ratodero, of whom 47% were females and 47% were aged <15 years. Of those tested, 73 (0.17%) were HIV-positive (48 persons aged <15 [0.24%] and 25 persons aged ≥15 [0.11%]) and 63 (86%) were linked to treatment. Forty eight persons (76%) reported exposure to reused needles or syringes. In surrounding areas, between 28 November to 12 December 2023, 24,352 individuals were tested, of whom 60% were females and 49% were aged <15 years. Of those tested, 158 (0.65%) were HIV-positive (56 persons aged <15 [0.47%] and 102 persons aged ≥15 [0.83%]) and 94 (59%) were linked to treatment. Forty seven persons (51%) reported reuse of needles or syringes and 15 (16%) transfusion of blood/blood products. Interpretation More than five years since the nosocomial HIV outbreak in Ratodero, undiagnosed HIV infections persist in the community. The undiagnosed HIV infection is common among children in Ratodero, and among both adults and children in surrounding areas. Self-reported HIV risk exposures point to reuse of needles and syringes as the predominant mode of transmission. The situation warrants urgent need to address unsafe injection practices and safety in healthcare facilities. Funding The educate, test and treat programme was funded through the Global Fund COVID-19 Response Mechanism country grant. No specific funding was received for this programme analysis and evaluation.
Identifying the trends and patterns of bioethics research in the Eastern Mediterranean Region provides valuable insights into research interests and productivity. This study aimed to evaluate the region's bioethics research outputs between 1974-2022 using a bibliometric approach. Publications from countries in the region indexed in Web of Science, Scopus, and PubMed were analysed. The results showed a clear upward trend, with an average annual growth rate of 39 per cent in bioethics publications, while the growth rate of citations was nearly twice as high. Iran was identified as the most prolific country, followed by Saudi Arabia and Pakistan. However, intra-regional and extra-regional co-authorships accounted for only 7 per cent and 17 per cent of publications, respectively, indicating limited research collaboration. The main non-regional collaborators were the United States, Canada, and the United Kingdom. Further development of bioethics research in the region requires strengthened capacity building at both national and regional levels.
BackgroundThe COVID-19 pandemic has greatly impacted the child protective services (CPS) globally, resulting in increased risks of violence against children (VAC). This study aims to assess the perceived impact of COVID-19 on CPS operations by CPS professionals from health, social, law enforcement, and educational sectors in Saudi Arabia.MethodsA cross-sectional survey was conducted between September 2021 and June 2022 among 257 CPS professionals from health, social, law enforcement, and educational sectors in Saudi Arabia. The questionnaire, developed with oversight by WHO, covered nine domains: violence trends, reporting and documentation, response and follow-up, legislation, resources, staff preparedness, prevention programs, knowledge, and challenges. Quantitative data were analyzed using descriptive statistics and Cramér’s V tests, while qualitative data were examined thematically.ResultsHealth sector professionals more frequently reported marked increases in the number of reported VAC cases and their severity compared to non-health participants. The results have shown limited change in reporting systems, with the exception of a few newly introduced mechanisms. Staff training, crisis preparedness, and digital infrastructure were insufficient, with limited remote follow-up. Qualitative findings highlighted family stress, financial hardship, and social isolation as risk factors. Major challenges included reduced case accessibility, weak inter-agency coordination, and inadequate protective measures.ConclusionThe study, conducted in the context of the COVID-19 pandemic in Saudi Arabia, reveals the need to further develop some aspects of CPS emergency preparedness. Strengthening intersectoral collaboration, investing in digital tools, enhancing staff training, and promoting community awareness are essential to ensure the resilience of CPS during similar future situations.
Recently, I attended the African Union Summit in Addis Ababa, which brings together Member States from both the WHO African Region (AFR) and the Eastern Mediterranean Region (EMR). The discussions highlighted a structural shift in global health: health systems are operating within the context of geopolitical fragmentation, prolonged crises and increasingly constrained and volatile external financing.
