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The WHO COVID-19 Clinical management: living guidance contains the Organization's most up-to-date recommendations for the clinical management of people with COVID-19. Providing guidance that is comprehensive and holistic for the optimal care of COVID-19 patients throughout their entire illness is important. The latest version of this living guideline is available in pdf format (via the 'Download' button) and via an online platform, and is updated regularly as new evidence emerges. No further updates to the previous existing recommendations were made in this latest version. This updated (fifth) version contains 16 new recommendations for the rehabilitation of adults with post COVID-19 condition (see Chapter 24), which includes: strong recommendation that exertional desaturation and cardiac impairment following COVID-19 should be ruled out and managed before consideration of physical exercise training

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The WHO Therapeutics and COVID-19: living guideline contains the Organization's most up-to-date recommendations for the use of therapeutics in the treatment of COVID-19. The latest version of this living guideline is available in pdf format (via the 'Download' button) and via an online platform, and is updated regularly as new evidence emerges. This twelfth version of the WHO living guideline now contains 19 recommendations. This latest update provides updated recommendations for remdesivir, addresses the use of combination therapy with corticosteroids, interleukin-6 (IL-6) receptor blockers and Janus kinase (JAK) inhibitors in patients with severe or critical COVID-19, and modifies previous recommendations for the neutralizing monoclonal antibodies sotrovimab and casirivimab-imdevimab in patients with non-severe COVID-19.

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The Global Leprosy Strategy 2021­2030 "Towards zero leprosy" was developed through a broad consultative process with all major stakeholders during 2019 and 2020. Valuable inputs were provided by national leprosy programme managers, technical agencies, public health and leprosy experts, funding agencies and persons or members of communities directly affected by leprosy. The Strategy aims to contribute to achieving the Sustainable Development Goals. It is structured along four pillars: ( i) implement integrated, country-owned zero leprosy road maps in all endemic countries; ( ii) scale up leprosy prevention alongside integrated active case detection; ( iii) manage leprosy and its complications and prevent new disability; and, ( iv) combat stigma and ensure human rights are respected. Interruption of transmission and elimination of disease are at the core of the Strategy

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La pandemia de la COVID 19 está provocando pérdidas humanas y económicas sin precedentes en todos los países y en todas las sociedades del mundo. De forma colectiva, la disponibilidad de vacunas seguras y efectivas frente al virus, tecnologías de diagnóstico y terapéuticas especializadas, así como el cumplimiento de las medidas sociales y de salud pública y la prevención de nuevas introducciones zoonóticas, son fundamentales para salvar más vidas. COVAX, el mecanismo del pilar de las vacunas del Acelerador del Acceso a las herramientas contra la COVID-19, tiene por finalidad acelerar el acceso equitativo de todos los países a vacunas adecuadas, seguras y efectivas. Para enero de 2021, había ya en desarrollo más de 200 candidatos a nuevas vacunas frente al coronavirus, de los cuales 64 en fase de ensayos clínicos. El London School of Hygiene & Tropical Medicine ha desarrollado una herramienta interactiva1 para seguir el progreso de estos candidatos a vacuna en tiempo real. Se recomienda la consulta periódica de esta herramienta para conocer el estado de desarrollo de estas potenciales vacunas, así como sus respectivos perfiles y posible cadena de temperatura controlada (CTC). Dado el contexto de pandemia, es posible que las vacunas no hayan sido precalificadas cuando comiencen a utilizarse, sino que se autorizarán según los procedimientos de la Lista de uso en emergencias ( ) de la Organización Mundial de la Salud (OMS). El procedimiento EUL fue desarrollado por la OMS para agilizar la disponibilidad y uso de productos médicos no autorizados en situaciones de emergencia de salud pública. En este contexto, es posible que algunas de las características del perfil de las vacunas no hayan sido determinadas en el momento del etiquetado para su uso. Por ejemplo, puede que aún no se conozcan la fecha de caducidad o el tipo de sensor de control del vial de la vacuna (SVV). Por tanto, será preciso aplicar prácticas y procedimientos rigurosos de suministro, distribución, logística y gestión durante el despliegue de la vacunación. La información mínima que debe constar en la etiqueta (ver abajo) y en el prospecto en los seis idiomas de las Naciones Unidas aún se está deliberando. Es posible que la etiqueta indique una fecha de fabricación en lugar de fecha de caducidad, y que esa fecha de caducidad se actualice posteriormente mediante datos de estabilidad en tiempo real accesibles a través de un código de barras que instaría a los usuarios a consultar una página web. Esta característica significa que hay una serie de nuevos requisitos en las actividades de gestión de las vacunas que deben aplicarse rigurosamente durante su despliegue.

The COVID-19 pandemic is causing unprecedented human and economic costs in all countries and societies across the world. Collectively, the availability of safe and effective vaccines against the virus, specialized diagnostics technologies and therapeutics, as well as adherence to public health and social measures, and preventing new zoonotic introductions, are instrumental in saving further lives. The vaccine pillar of the Access to COVID-19 Tools Accelerator (COVAX) Facility aims to accelerate equitable access to appropriate, safe and efficacious vaccines for all countries. As of January 2021, over 200 novel coronavirus vaccine candidates are under development, of which 64 are in clinical trials. The London School of Hygiene & Tropical Medicine has developed an interactive tool1 that tracks the progress of the candidate vaccines in real time. It is recommended to access it regularly to verify the status of the vaccines' development progress, profiles and potential controlled temperature chain (CTC). Given the pandemic context, the vaccines may not be prequalified during their initial periods of use; they will be released under World Health Organization (WHO) Emergency Use Listing (EUL) ( ) procedures. The EUL process was developed by WHO to expedite the availability and use of unlicensed medical products needed in public health emergency situations. In this context, it is possible that some vaccine profile characteristics will not be established by the time they are labelled for use. For example, the expiry date and vaccine vial monitor (VVM) category may not be established. Consequently, strict supply, distribution, logistics and management procedures and practices must be applied throughout the vaccination deployment. The minimum label information (shown below) and package insert in six United Nations (UN) languages are under consideration. The label may include a manufacturing date rather than an expiry date and the expiry date could be updated through real-time stability data accessible via a barcode that would direct users to a website. This characteristic represents new requirements of vaccine management activities that need to be handled appropriately in the field.

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This interim guidance has been developed on the basis of the advice issued by the Strategic Advisory Group of Experts on Immunization (SAGE) at its extraordinary meeting on 8 February 2021.

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This report responds to the Seventy-third World Health Assembly's request for a report on progress made in implementing its decision WHA73(11) (2020). The accompanying document annexed to this report sets out the final version of the implementation plan to guide further action on the prioritized recommendations of the review panel, established at the request of the Sixty-eighth World Health Assembly (resolution WHA68.18 (2015)) to conduct an overall programme review of the global strategy and plan of action on public health, innovation and intellectual property. (AU)

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This interim guidance has been developed on the basis of the advice issued by the Strategic Advisory Group of Experts on Immunization (SAGE) at its extraordinary meeting on 21 January 2021.

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This interim guidance has been developed based on the advice issued by the Strategic Advisory Group of Experts on Immunization (SAGE) at its 5 January 2021 extraordinary meeting.

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Contact tracing is a key element of WHO's recommended approach to control the spread of COVID-19 by breaking the chains of human-to-human transmission. By effectively embedding risk communication and community engagement ( RCCE) principles in contact-tracing efforts in the context of COVID-19, compliance with contact-tracing efforts is safeguarded and transmission of COVID-19 is slowed or halted, ultimately reducing death and disease due to COVID-19 and mitigating the negative impact on health-care systems and economies. This document provides guidance to health authorities at all levels to improve the success rate of contact tracing by informing efforts with RCCE principles, evidence and activities, and provides ready-to-use tools for professionals involved in contact-tracing efforts to inform their practices with RCCE principles and likewise improve their success rate.

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Countries face a multitude of questions and decisions that must be addressed to prepare for and respond directly to the COVID-19 pandemic while simultaneously maintaining the delivery of other health services. Key decisions and actions to mitigate the risk of potential health system collapse must be informed by accurate and timely data collected through ongoing monitoring of health service delivery and utilization throughout all phases of the COVID-19 pandemic. Rapid and accurate assessments of health service capacities ­ including management structures and processes, health worker capacity and protection, resources, supply-chain management, and community needs ­ are essential for planning high-quality service delivery and the related redistribution of resources. This suite of modules is designed to meet country needs throughout the different phases of COVID-19 preparedness, response and recovery, and is aligned and consistent with all published WHO guidance on COVID-19. Its primary aim is to support rapid and accurate assessments of the current, surge and future capacities of health facilities, so that they are prepared for and responsive to COVID-19 while maintaining the delivery of essential health services throughout all phases of the pandemic.

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This guidance document is directed at national authorities who are responsible for managing deployment, implementation and monitoring of COVID-19 vaccines, as well as partners who provide the required support. As in most countries the establishment of a COVID-19 vaccine deployment and vaccination mechanism falls with the ministry of health (MoH), this guidance document is intended to support them as they develop the coordination mechanisms across all sectors of government and multistakeholders.

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The World Health Organization organized a Consultation of National Leprosy Programme managers, partners and affected persons to discuss the draft Global Leprosy Strategy, 2021--2030. This virtual event took place from 26 to 30 October 2020. It was attended by more than 450 stakeholders. Contributions were shared through 70 presentations made by stake holders from all Regions. The presentations covered the key strategic approaches: global context, challenges in countries, contact tracing and post exposure prophylaxis, disability care, interruption of transmission and elimination of disease, stigma and d iscrimination, research. In addition to numerous comments received through the chat box and by email, the conclusions and recommendations of this Consultation will guide finalizing the post 2020 Global Leprosy Strategy

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Health systems around the world are being challenged by increasing demand for care of people with COVID-19, compounded by fear, stigma, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. When health systems are overwhelmed and people fail to access needed care, both direct mortality from an outbreak and indirect mortality from preventable and treatable conditions increase dramatically (1, 2, 3). Maintaining population trust in the capacity of the health system to safely meet essential needs and to control infection risk in health facilities is key to ensuring appropriate care-seeking behaviour and adherence to public health advice. Any system's ability to maintain the delivery of essential health services will depend on its baseline burden of disease, the local COVID-19 transmission scenario (classified as no cases, sporadic, clusters or community transmission) and the health system capacity as the pandemic evolves (4). Recent investments in primary health care for universal health coverage provide a critical foundation for adapting to the pandemic context. A well organized and prepared health system has the capacity to maintain equitable access to high-quality essential health services throughout an emergency, limiting direct mortality and avoiding indirect mortality. In the early phases of the COVID-19 outbreak, many health systems have been able to maintain routine service delivery in addition to managing a relatively limited COVID-19 case-load. As demands on systems have surged and health workers themselves have increasingly been affected by COVID-19 infection and the indirect consequences of the pandemic, strategic adaptations have become urgent to ensure that limited public and private sector resources provide the maximum benefit for populations. Countries are making difficult decisions to balance the demands of responding directly to the COVID-19 pandemic with the need to maintain the delivery of other essential health services. Establishing safe and effective patient flow (including screening for COVID-19, triage and targeted referral) remains critical at all levels. Many routine and elective services have been suspended, and existing delivery approaches are being adapted to the evolving pandemic context as the risk­benefit analysis for any given activity changes. When the delivery of essential health services comes under threat, effective governance and coordination mechanisms, and protocols for service prioritisation and adaptation, can mitigate the risk of outright system failure. As the outbreak is brought under control and restrictive public health measures are gradually eased, some adaptations in service delivery may need to be reversed, others continued for a limited time, and yet others that are found to be effective, safe and beneficial can be incorporated into routine post-pandemic practice. The course of the outbreak is likely to wax and wane, and the strategic response will need to be dynamic and calibrated. Decision-makers should anticipate the need to start, stop and restart adaptations. Decisions should be aligned with relevant national and subnational policies and should be re-evaluated at regular intervals. Successful implementation of these strategic shifts will require the active engagement of communities and public and private stakeholders, specific measures to ensure access for socially vulnerable populations, transparency and frequent communication with the public and a high degree of cooperation from individuals.

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Coronavirus disease 2019 (COVID-19) is a respiratory infection caused by SARS-CoV-2 (COVID-19 virus). The COVID-19 virus is transmitted mainly through close physical contact and respiratory droplets, while airborne transmission is possible during aerosol generating medical procedures.1 At time of publication, transmission of the COVID-19 virus had not been conclusively linked to contaminated environmental surfaces in available studies. However, this interim guidance document has been informed by evidence of surface contamination in health-care settings2 and past experiences with surface contamination that was linked to subsequent infection transmission in other coronaviruses. Therefore, this guidance aims to reduce any role that fomites might play in the transmission of COVID-19 in health-care3 and non-health care settings. 4

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This interim guidance is intended to inform public health programmes and governments that are considering whether to develop or implement digital proximity tracking technologies for COVID-19 contact tracing. The document covers ethical principles, technical considerations and requirements that are consistent with these principles; and how to achieve equitable and appropriate use of such technologies. Contact tracing is the process of identifying, assessing, and managing people who have been exposed to a disease to prevent onward transmission. When systematically applied, contact tracing will break the chains of transmission of an infectious disease and is thus an essential public health tool for controlling infectious disease outbreaks. For contact tracing to be effective, countries need adequate capacity, including human resources, to test suspect cases in a timely manner.1 Digital technology can play a role in contact tracing programmes implemented in Member States. Member States are obliged under the International Health Regulations to develop public health surveillance systems2 that capture critical data for their COVID-19 response, while ensuring that such systems are transparent, responsive to the concerns of communities, and do not impose unnecessary burdens, for example infringements on privacy. 3 Failure to implement effective surveillance systems can hamper an effective public health and clinical response.4 Digital technologies are used in public health surveillance to support rapid reporting, data management and analysis. Especially when combined with machine learning and artificial intelligence, they could constitute powerful tools that provide public health agencies with valuable information to make appropriate decisions.5 One form of digital technology for surveillance that has been receiving attention in many countries facing COVID-19 epidemics in recent months is proximity tracking. Proximity tracking measures signal strength to determine whether two devices [e.g. smartphones] were close enough together for their users to spread the virus from an infected individual to an uninfected person. If one user is infected, others who have been identified as within proximity of the other person can be notified, and thereby take appropriate steps to reduce health risks to themselves and others.6 Proximity tracking is often conflated with 'contact tracing', although contact tracing is a broad public health discipline, and proximity tracking is a new technique for aiding contact tracing.

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The proposed definition qualifies Digital Health as going beyond the rather simplistic meaning of the use of digital technologies in health. When understood as a broader field of knowledge and practice, Digital Health becomes more comprehensive and able to foster the diversity required to understand its multiple categories, functions and corresponding policy needs. It also ensures that digital technologies are understood as a means to an end. As a result, this definition also anchors Digital Health to matters linked to its practical application and demonstrated, measurable outcomes for improvements in health. The following Global Strategy on Digital Health is designed to help countries achieve this objective. It sets out a vision, strategic objectives and a framework for action to advance digital health. The Global Strategy is developed in collaboration with countries and other stakeholders, considering their cultures, values and interests. The Strategy leads to concrete actions within the proposed timeframe of four years, from 2020 to 2024. However, the strategic objectives aim to set the actions for a longer period and can be reviewed and revised after the proposed timeframe.The Strategy builds on previous WHA resolutions4 WHO global and regional reports on digital health, eHealth, mHealth, telehealth and other digital health related areas5,6,7 and a two-part ISO TC 215 Technical Specification8 . In particular, the National eHealth Strategy Toolkit9 , co-published by WHO and ITU, is an essential source of inspiration and methods. It provides an excellent and easy to use operational model, with step-by-step instructions that systematizes a simple but comprehensive framework for preparing and implementing National Digital Health Strategies

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Traditional and complementary medicine (T&CM) is an important and often underestimated health resource with many applications, especially in the prevention and management of lifestyle-related chronic diseases, and in meeting the health needs of ageing populations. This report reviews global progress in T&CM over the past two decades and is based on contributions from 179 WHO Member States. It clearly shows that more and more countries are recognizing the role of T&CM in their national health systems. According to the report, progress in the countries worldwide in this area is significant in the past twenty years and showed a growing trend. The report shows that there are 170 countries acknowledged the use of traditional medicine (TM); the number of countries with legal and regulatory framework for TM increased from 79 in 2012 to 109 in 2018; 124 countries reported having laws or regulations on herbal medicines.

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In introducing this document, we wish to reiterate the commitment of the staff and the Association to the vision, mission, and values of the Organization. We are always mindful that the values of equity, excellence, solidarity, respect, and integrity should guide our actions and inspire new generations to better understand why we work for an institution like the Pan American Health Organization (PAHO). The Association is an internal agent dedicated to supporting and working together to create a workplace environment that fosters high individual and organizational performance aimed at achieving the impact sought by the Member States to improve public health in our Hemisphere. On this occasion, the Staff Association will be reporting to the Executive Committee on the following topics: a) relations between the Association and Executive Management; b) the importance of a working environment that promotes trust and creativity; and c) a responsive system of internal justice. (AU)

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Introduction 1. The Staff Regulations of the Pan American Sanitary Bureau (PASB) may be supplemented or amended by the Directing Council or the Pan American Sanitary Conference of the Pan American Health Organization (PAHO) pursuant to Staff Regulation 12.1. 2. In accordance with Staff Rule 020, the Staff Rules of the PASB may be amended by the Director, subject to confirmation by the Executive Committee of PAHO. 3. Accordingly, the Director will submit for confirmation to the 162nd Session of the Executive Committee the amendments to the Staff Rules issued by the Director since the Committee's 160th Session (Annex A). (AU)

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