Littérature scientifique sur le sujet « World Health Organization (WHO) Eastern Mediterranean Region »

Studies done between 1997 and 2003 are reviewed to give an overall picture of antimalarial drug resistance in the Eastern Mediterranean Region of the World Health Organization [WHO]. The situation in 8 countries where resistance has been reported is detailed. It has been difficult to abandon chloroquine as first-line treatment even though resistance to it is widespread. Resistance to sulfadoxine-pyrimethamine has also been detected. The spread of resistance could be slowed down by the adoption of effective national policies and control programmes. Coordination between counties and with other WHO regions, as opposed to working in isolation, could further reduce the spread of resistance.

Background: Schools provide an exceptional opportunity for mental health promotion and intervention. Aims: To describe the development of a World Health Organization (WHO) mental health in schools programme in the Eastern Mediterranean Region. Methods: Two tenets guided development of the mental health in schools programme: (1) it used a multitiered system of support framework that includes 3 tiers of interventions (universal, early and targeted); and (2) interventions that must be feasible for implementation by non-mental health professionals. Results: The WHO mental health in schools programme manual is organized into a background section, followed by 3 modules: social–emotional childhood development; mental health promoting schools (promotion and prevention); and addressing student mental health problems in your classroom, including specific classroom strategies and case examples. Conclusion: Developing an appropriate curriculum that is sensitive to the needs of individual countries requires involvement of those familiar with schooling in those countries. It should include mental health priorities and practices that promote mental health, and coalesce school staff, parents and community members in support of their children

Trichinellosis is a foodborne zoonosis caused by the parasitic nematode Trichinella, which is characterized by an extremely wide host range and geographical distribution. The aim of the present review is to provide epidemiological information on animal and human trichinellosis occurring in developing countries in the different continents, where cooking habits along with poverty and poor sanitary conditions and lack of veterinary controls may facilitate the occurrence of human trichinellosis outbreaks. Countries have been considered according to the six regions designated by the World Health Organization (WHO): 1) WHO African Region, 2) WHO Region of the Americas, 3) WHO South-East Asia Region, 4) WHO European Region, 5) WHO Eastern Mediterranean Region, and 6) WHO Western Pacific Region. For the purposes of this article, developing countries are defined as those not industrialised according to the World Economic Outlook Report of the International Monetary Fund (http://www.imf.org); however, with regard to the European Region of WHO, only those countries that are not member states of the European Union will be considered.

Evidence regarding the adverse burden of severe neonatal jaundice (SNJ) in hospitalized neonates in resource-constrained settings is sparse. We attempted to determine the prevalence of SNJ, described using clinical outcome markers, in all World Health Organization (WHO) regions in the world. Data were sourced from Ovid Medline, Ovid Embase, Cochrane Library, African Journals Online, and Global Index Medicus. Hospital-based studies, including the total number of neonatal admissions with at least one clinical outcome marker of SNJ, defined as acute bilirubin encephalopathy (ABE), exchange blood transfusions (EBT), jaundice-related death, or abnormal brainstem audio-evoked response (aBAER), were independently reviewed for inclusion in this meta-analysis. Of 84 articles, 64 (76.19%) were from low- and lower-middle-income countries (LMICs), and 14.26% of the represented neonates with jaundice in these studies had SNJ. The prevelance of SNJ among all admitted neonates varied across WHO regions, ranging from 0.73 to 3.34%. Among all neonatal admissions, SNJ clinical outcome markers for EBT ranged from 0.74 to 3.81%, with the highest percentage observed in the African and South-East Asian regions; ABE ranged from 0.16 to 2.75%, with the highest percentages observed in the African and Eastern Mediterranean regions; and jaundice-related deaths ranged from 0 to 1.49%, with the highest percentage observed in the African and Eastern Mediterranean regions. Among the cohort of neonates with jaundice, the prevalence of SNJ ranged from 8.31 to 31.49%, with the highest percentage observed in the African region; EBT ranged from 9.76 to 28.97%, with the highest percentages reported for the African region; ABE was highest in the Eastern Mediterranean (22.73%) and African regions (14.51%). Jaundice-related deaths were 13.02%, 7.52%, 2.01% and 0.07%, respectively, in the Eastern Mediterranean, African, South-East Asian and European regions, with none reported in the Americas. aBAER numbers were too small, and the Western Pacific region was represented by only one study, limiting the ability to make regional comparisons. The global burden of SNJ in hospitalized neonates remains high, causing substantial, preventable morbidity and mortality especially in LMICs.

The response to the COVID-19 pandemic have been driven by epidemiology, health system characteristics and control measures in form of social/physical distancing. Guidance, information and best practices have been characterized by territorial thinking with concentration on national health system and social contexts. Information was to a large extent provided from global entities such as the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) and others. This bipolar response mechanism came to the detriment of regional and sub-regional levels. The development of the global pandemic was evaluated in terms of the performance of single countries without trying to reflect on possible regional or sub-regional results of similar characteristics in health system and social contexts. To have a clearer view of the issue of sub-regional similarities, we examined the WHO, Eastern Mediterranean Region. When examining the development of confirmed cases for countries in the region, we identified four different sub-groups similar in the development of the pandemic and the social distancing measure implemented. Despite the complicated situation, these groups gave space for thinking outside the box of traditional outbreaks or pandemic response. We think that this sub-regional approach could be very effective in addressing more characteristics and not geographically based analysis. Furthermore, this can be an area of additional conceptual approaches, modelling and concrete platforms for information and lessons learned exchange.

Introduction: Tuberculosis (TB) remains a global emergency and is one of the major threats to human and public health, more than 60 years of its medical treatment, as well as the economic and social development of societies. More than 2 billion individuals are infected with mycobacterium, causing the morbidity and mortality of 10 and 2 million individuals, respectively. The current study was accomplished aiming to investigate the TB disease status and indicators of achieving the goal of ending the TB epidemics by 2035. Methods: This was a comparative study conducted in a library and the main source of information used included the reports published by the World Health Organization (WHO) and its regional organizations profile, the United Nations Development Program (UNDP), World Bank Group (WBG), and studies. Results: The highest incidence rate was in Africa and South-East Asia, with the lowest incidence in the Americas and Europe regions. In the Eastern Mediterranean region, the incidence of extrapulmonary TB (EPTB) was about 10% higher than in other areas. The highest success rate of TB treatment was in the Western Pacific region and the lowest in the United States and Europe. Conclusion: Over 1 billion US dollars have been spent in funding for the fight against TB. Health policymakers, especially in the Middle Eastern region, should pay particular attention to allocating national and local resources to this disease and rely less on international and humanitarian resources. In order to achieve the goal of ending the TB epidemic END-TB 2035, in addition to addressing the economic and social well-being of citizens, it is essential to focus on early detection and diagnosis of disease and effective treatment with strategy implementation [Directly Observed Treatment Short course (DOTS)].

Background A life-course immunization approach would enhance the quality of life across all age groups and improve societal well-being. The herpes zoster (HZ) vaccine is highly recommended for older adults to prevent HZ infection and related complications. The proportions of willingness to receive the HZ vaccine varies across countries, and various kinds of factors, including sociodemographics and individual perceptions, influence the willingness to vaccinate. Objective We aim to estimate the HZ vaccination willingness rate and identify factors associated with vaccine uptake willingness across all World Health Organization (WHO) regions. Methods A global systematic search was performed on PubMed, Web of Science, and the Cochrane Library for all papers related to the HZ vaccine published until June 20, 2022. Study characteristics were extracted for each included study. Using double arcsine transformation, vaccination willingness rates with 95% CIs were pooled and reported. The willingness rate and associated factors were analyzed by geographical context. Associated factors were also summarized based on Health Belief Model (HBM) constructs. Results Of the 26,942 identified records, 13 (0.05%) papers were included, covering 14,066 individuals from 8 countries in 4 WHO regions (Eastern Mediterranean Region, European Region, Region of the Americas, and Western Pacific Region). The pooled vaccination willingness rate was 55.74% (95% CI 40.85%-70.13%). Of adults aged ≥50 years, 56.06% were willing to receive the HZ vaccine. After receiving health care workers’ (HCWs) recommendations, 75.19% of individuals were willing to get the HZ vaccine; without HCWs’ recommendations, the willingness rate was only 49.39%. The willingness rate was more than 70% in the Eastern Mediterranean Region and approximately 55% in the Western Pacific Region. The willingness rate was the highest in the United Arab Emirates and the lowest in China and the United Kingdom. The perception of HZ severity and susceptibility was positively associated with vaccination willingness. The perceived barriers to vaccination willingness (main reasons for unwillingness) included low trust in the effectiveness of the HZ vaccine, concerns about safety, financial concerns, and being unaware of the HZ vaccine’s availability. Older individuals, those having lower education, or those having lower income levels were less likely to willing to be vaccinated. Conclusions Only 1 in 2 individuals showed a willingness to be vaccinated against HZ. The willingness rate was the highest in the Eastern Mediterranean Region. Our findings show the critical role HCWs play in promoting HZ vaccination. Monitoring HZ vaccination willingness is necessary to inform public health decision-making. These findings provide critical insights for designing future life-course immunization programs.

Thesis (M.P.H.)--Georgia State University, 2008.
Title from file title page. Frances McCarty, committee chair; Derek G. Shendell, co-chair; Ike S Okosun, committee member. Electronic text (140 p. : col. ill., col. maps) : digital, PDF file. Description based on contents viewed July 15, 2008. Includes bibliographical references (p. 103-108).

By 2020, cancer mortality rates are estimated to increase by 180% in Arab countries, where breast cancer is the most common type of cancer. This thesis explores and evaluates the ‘asabiyya-driven structuration (the cohesive force of the group that gives it strength in facing its struggles for progressive reproduction) of cancer agents, government agents, and the World Health Organization agents for breast cancer prevention and early detection in the Arab region. The layers of the philosophical standing from Ibn Khaldûn’s concept of ‘asabiyya and the theoretical foundation of social systems theory, structuration theory, social network analysis, and social capital theory are peeled in order to explore and evaluate the context, constraints, social networks, autopoiesis, and social capital. Utilizing a qualitative research design, this thesis employs content analysis and in-depth interviews, as well as NVivo as a tool for analysis. Data is collected from 122 publications and knowledgeable informants employed by cancer agencies, ministries of health, and World Health Organization offices in Egypt, Jordan, Morocco, and Oman. The findings are divided into the contextual scope of responsibility and resources, the progressive and hierarchal constraining structure, the optimal and weak social networks, the strong and vulnerable shields of autopoiesis, and the presence and absence of social capital momentum, followed by a discussion on the the struggle for structuration against breast cancer. The findings demonstrate that countries with a national cancer control program witness local strengthening ‘asabiyya and ‘asabiyya-driven structuration, while those without a national cancer control program witness weakening local ‘asabiyya. Ultimately, this thesis proposes strategic recommendations to accelerate the regional ‘asabiyya-driven structuration of breast cancer.

AbstractLibya is a large country, ranking at fourth in terms of area both in the Arab world and the African continent (https://www.worldatlas.com/articles/which-are-the-10-largest-countries-of-africa-by-size.html). It is part of the World Health Organization–Eastern Mediterranean Regional Office (WHO–EMRO) region. Oil production is the main source of income which has transformed the country massively over the past 50 years and the healthcare system is one of the sectors that have improved significantly. The Health Act No (106), issued in 1973, guarantees free health services to all Libyans, with inevitable challenges regarding the delivery of adequate and sustainable services. The health system in Libya is a mix between the public sector and the private sector. The private sector is basically depending on funding through insurance companies and self-pay. It is not yet adequately developed but is striving and rapidly growing in the last two decades.The oncology services are accessible and available for all Libyans, most of the diagnostic and therapeutic facilities are of good standards and the modern treatments like immunotherapy and targeted therapies are also available. However, there were periods when the health care system—in general—was struggling to meet the increasing demand on health services and has seen considerable challenges, especially over the past few years due to the conflict, political, and economic instability of the country. This chapter covers the oncology care in Libya, describing the current state, challenges, and future directions.

AbstractThe concentrations of polychlorinated biphenyls (PCB), polychlorinated dibenzo-p-dioxins (PCDD), and polychlorinated dibenzofurans (PCDF) were determined in 232 pooled human milk samples from 82 countries from all United Nations regions participating in five exposure studies coordinated by the World Health Organization (WHO) and the United Nations Environment Programme (UNEP) between 2000 and 2019.The highest concentrations of PCB were found in European countries. Countries of all other regions had considerably lower concentrations.The highest median concentrations of toxic equivalents (TEQ) of PCDD/PCDF and dioxin-like PCB (expressed as WHO2005-TEQ) were found in Eastern and Western European countries, the widest variation in Africa. The median concentrations and maximum levels in the Pacific region and countries from Latin America and the Caribbean were at the lower end of the distribution. However, also time trends have to be considered for this overall picture for a period of 20 years.

AbstractThe concentrations of a number of organochlorine pesticides and related chemicals and two organochlorine industrial chemicals were determined in 163 pooled human milk samples from 82 countries from all United Nations regions. These countries participated in one or more of the five exposure studies on persistent organic pollutants coordinated by the World Health Organization and the United Nations Environment Programme between 2000 and 2019. The compounds included were aldrin, chlordane, chlordecone, DDT, dicofol, dieldrin, endosulfan, endrin, heptachlor, hexachlorobenzene, hexachlorobutadiene, hexachlorocyclohexanes, mirex, pentachlorobenzene, pentachlorophenol/pentachloroanisole, and toxaphene.Large differences were found for DDT with the highest concentrations found in Africa. However, the median levels of the DDT concentrations of all samples show a decrease of 72% from the 2000–2003 period to the 2016–2019 period, with considerable differences between regions. Due to metabolization of hexachlorocyclohexanes (HCH) in humans, the concentrations of alpha-HCH and gamma-HCH were below the limit of quantification in most human milk samples. The ranges of beta-HCH found in the five periods varied considerably among UN regions, with a maximum found in 2002 in the Asia subgroup of the Asia-Pacific region. A decrease of the median concentrations of all samples of 91% was found from the 2000–2003 period to the 2016–2019 period. In comparison with DDT and beta-HCH, the ranges for hexachlorobenzene (HCB) were much lower with a maximum found in the samples from Eastern Europe. Other organochlorine pesticides and contaminants and their metabolites were found mostly in ranges of low background contamination; some were below the limits of quantification.

AbstractBuilding on the two rounds of exposure studies with human milk coordinated by the World Health Organization (WHO) in the mid-1980s and 1990s on polychlorinated biphenyls (PCB), polychlorinated dibenzo-p-dioxins (PCDD), and polychlorinated dibenzofurans (PCDF), five expanded studies on persistent organic pollutants (POPs) were performed between 2000 and 2019. After the adoption of the Stockholm Convention on POPs (the Convention) in 2001, WHO and the United Nations Environment Programme (UNEP) collaborated in joint studies starting in 2004. The collaboration aimed at provision of POPs data for human milk as a core matrix under the Global Monitoring Plan (GMP) to assess the effectiveness of the Convention as required under Article 16. Over time, the number of analytes in the studies expanded from the initial 12 POPs targeted by the Convention for elimination or reduction to the 30 POPs covered under the Stockholm Convention and two other POPs proposed for listing as of 2019. Many of these chemicals have numerous congeners, homologous groups, isomeric forms, and transformation products, which significantly extends the number of recommended analytes.In the studies between 2000 and 2019, 82 countries from all five United Nations regions participated, of which 50 countries participated in more than one study. For the human milk samples of the 2016–2019 period, results are available for the full set of 32 POPs of interest for the Convention until 2019: (i) the 26 POPs listed by the start of the study in 2016; (ii) decabromodiphenyl ether [BDE-209] and short-chain chlorinated paraffins [SCCP] as listed in 2017; (3) dicofol and perfluorooctanoic acid [PFOA] as listed in 2019; (4) medium-chain chlorinated paraffins [MCCP] and perfluorohexane sulfonic acid [PFHxS] as proposed for listing. This is a unique characteristic among the core matrices under the GMP.Four key messages can be derived: These studies are an efficient and effective tool with global coverage as key contributor to the GMP. After collection of a large number of individual samples (usually 50) fulfilling protocol criteria, pooled samples are prepared using equal aliquots of individual samples (physical averaging) and are considered to be representative for a country, subregion or subpopulation at the time of the sampling. The analysis of pooled representative human milk samples by dedicated Reference Laboratories meeting rigorous quality criteria contributes to reliability and comparability and reduces uncertainty of the analytical results. Additionally, this concept is very cost-effective. These studies can be used for regional differentiation based on concentrations of individual POPs between and within the five UN Regional Groups (African Group, Asia-Pacific Group, Eastern European Group, Group of Latin American and Caribbean Countries; Western European and Others Group). For some POPs, a wide range of concentrations with up to three orders of magnitude between lower and upper concentrations was found, even for countries in the same UN region. Some countries had levels within the usual range for most POPs, but high concentrations for certain POPs. Findings of concentrations in the upper third of the frequency distribution may motivate targeted follow-up studies rather than if the observed level of a POP is found in the lower third of frequency distribution. However, the concentration of a POP has also to be seen in context of the sampling period and the history and pattern of use of the POPs in each country. Therefore, results are not intended for ranking of individual countries but rather to distinguish broader patterns. These studies can provide an assessment of time trends, as possible sources of variation were minimized by the survey concepts building on two factors (sampling design; analysis of the pooled samples by dedicated Reference Laboratories). The estimation of time trends based on comparison of median or mean concentrations in UN Regional Groups over the five surveys in five equal four-year periods between 2000 and 2019 provides a first orientation. However, the variation of the number of countries participating in a UN Regional Group in a certain period can influence the median or mean concentrations. Thus, it is more prudent to only use results of countries with repeated participation in these studies for drawing conclusions on temporal trends. The reduction rates in countries should be seen in context with the concentration range: A differentiation of high levels and those in the range of the background contamination is meaningful. If high levels are found, sources might be detected which could be eliminated. This can lead to significant decrease rates over the following years. However, if low background levels are reported, no specific sources can be detected. Other factors for exposure, e.g. the contamination of feed and food by air via long-range transport and subsequent bioaccumulation, cannot be influenced locally. However, only very few time points from most individual countries for most POPs of interest are available, which prevents the derivation of statistically significant temporal trends in these cases. Yet, the existing data can indicate decreasing or increasing tendencies in POP concentrations in these countries. Furthermore, pooling of data in regions allows to derive statistically significant time trends in the UN Regional Groups and globally. Global overall time trends using the data from countries with repeated participation were calculated by the Theil–Sen method. Regarding the median levels of the five UN Regional Groups, a decrease per 10 years by 58% was found for DDT, by 84% for beta-HCH, by 57% for HCB, by 32% for PBDE, by 48% for PFOS, by 70% for PCB, and by 48% for PCDD and PCDF (expressed as toxic equivalents). In contrast, the concentrations of chlorinated paraffins (CP) as “emerging POPs” showed increasing tendencies in some UN Regional Groups. On a global level, a statistically significant increase of total CP (total CP content including SCCP [listed in the Convention in 2017] and MCCP [proposed to be listed]) concentrations in human milk of 30% over 10 years was found. The studies can provide the basis for discussion of the relative importance (“ranking”) of the quantitative occurrence of POPs. This, however, requires a differentiation between two subgroups of lipophilic substances ([i] dioxin-like compounds, to be determined in the pg/g [=ng/kg] range, and [ii] non-dioxin-like chlorinated and brominated POPs, to be determined in the ng/g [=μg/kg] range; both groups reported on lipid base) and the more polar perfluorinated alkyl substances (PFAS); reported on product base [as pg/g fresh weight] or on volume base [ng/L]. For this purpose, results for the complete set of the 32 POPs of interest for the 2016–2019 period were considered. By far, the highest concentrations of lipophilic substances were found for DDT (expressed as “DDT complex”: sum of all detected analytes, calculated as DDT; maximum: 7100 ng/g lipid; median: 125 ng/g lipid) and for chlorinated paraffins (total CP content; maximum: 700 total CP/g lipid; median: 116 ng total CP/g lipid). PCB was next in the ranking and had on average an order of magnitude lower concentrations than the average of the total CP concentrations. The high CP concentrations were caused predominantly by MCCP. If the pooled samples from mothers without any known major contamination source nearby showed a high level of CP, some individual samples (e.g. from local population close to emission sources, as a result of exposure to consumer products or from the domestic environment) might even have significantly higher levels. The lactational intake of SCCP and MCCP of the breastfed infant in the microgram scale resulting from the mothers’ dietary and environmental background exposure should therefore motivate targeted follow-up studies and further measures to reduce exposure (including in the case of MCCP, regulatory efforts, e.g. restriction in products). Further, due to observed levels, targeted research should look at the balance among potential adverse effects against positive health aspects for the breastfed infants for three groups of POPs (dioxin-like compounds; non-dioxin-like chlorinated and brominated POPs; PFAS) regarding potentially needed updates of the WHO guidance. As an overall conclusion, the seven rounds of WHO/UNEP human milk exposure studies are the largest global survey on human tissues with a harmonized protocol spanning over the longest time period and carried out in a uniform format. Thus, these rounds are an effective tool to obtain reliable and comparable data sets on this core matrix and a key contributor to the GMP. A comprehensive set of global data covering all POPs targeted by the Stockholm Convention, in all UN Regional Groups, and timelines covering a span of up to three decades allows to evaluate data from various perspectives. A widened three-dimensional view is necessary to discuss results and can be performed using the three pillars for assessments of the comprehensive data set, namely: analytes of interest; regional aspects; time trends. This can identify possible problems for future targeted studies and interventions at the country, regional, or global level. Long-term trends give an indication of the effectiveness of measures to eliminate or reduce specific POPs. The consideration of countries with repeated participation in these studies provides the best possible database for the evaluation of temporal trends. The continuation of these exposure studies is important for securing sufficient data for reliable time trend assessments in the future. Therefore, it is highly recommended to continue this monitoring effort, particularly for POPs that are of public health concern.

The COVID-19 pandemic occurred in the world in January 2020. Without specific vaccines and antiviral treatments, the virus easily spreads across different parts of the world. Accordance to the World Health Organization (WHO), COVID-19 has widely spread to nearly all countries across six geographical regions (i.e., Western Pacific, Africa, Eastern Mediterranean, South-East Asia, Europe, and Americas). In doing so, different countries implemented various preventive measures like hand washing, lockdowns, social distancing, and mask-wearing to minimize the transmission of the virus. However, such preventive measures are short-term, ineffective, and may not be sustainable. The introduction of common vaccination campaigns is viewed as a vital effective way to against COVID-19. Over 60 vaccines for COVID-19 are either previously endorsed or going through clinical experiments. As expected, there will be an increasing need for people to accept vaccine injections. The vaccine is a highly vulnerable, high-value, and rare product in the world. As such, resilient vaccine supply chain management is urgently needed. Otherwise, the inferior quality of vaccines poses global health risks and causes the problem of wasting useful medical supplies. Nevertheless, some logistics firms encountered unfolded logistics challenges of the COVID-19 vaccine due to a lack of professionals, capacity, data integrity, inventory management, fluctuating demand, and geographic risk (e.g., vibration, location, shock, and temperature. In particular, most logistics firms and health specialists encounter severe challenges in managing the vaccine supply chain in remote areas or developing countries. Although the vaccine is a global and hot issue for researchers, industrial practitioners, local communities, and policymakers, there is scanty attention to investigating the establishment of a resilience vaccine supply chain management in the context of COVID-19. At present, only a few research groups have discussed the role of blockchain in vaccine supply chain management, however, the information is not enough to reveal the impact on how vaccine supply chain management of blockchain can mitigate the COVID-19 crisis. Therefore, this chapter will mainly focus on the overview of the influenza pandemic around the globe, the existing situation of the COVID-19 pandemic in the world and Hong Kong, the current development of vaccines during the COVID-19 pandemic, the adoption of blockchain in the vaccine supply chain, and the vaccine logistics in COVID-19.

Eastern Europe and the Soviet Union were significant actors in the dynamics and development of post-1945 regimes of global health. This chapter explores how expertise in disease eradication and basic health services that had been developed in interwar Eastern Europe—often with the assistance of the League of Nations—became part of new socialist health interventions on a global scale at the World Health Organization (WHO). The region’s predominantly rural character in the first decades of the twentieth century and socialism’s self-definition as the solution to backwardness helped establish their medical initiatives as models for overcoming disease and deprivation in the post-colonial world in Africa and Asia too. The export of such blueprints of modernity was achieved through involvement in WHO schemes (e.g. eradication programmes for malaria, smallpox, poliomyelitis), through humanitarian assistance, or in aid to national liberation movements. Such interventions were presented as humane alternatives to liberal medicine, but were challenged by Chinese and Cuban regimes. For them, European socialist medicine reproduced civilizational hierarchies , as became particularly apparent with the erosion of its commitment to rural medicine outside Europe. From the late 1970s, the profile of Eastern European medical internationalism changed: pharmaceutical multi-nationals from the region grew in the South and healthcare was increasingly commercialized, whilst states provided only limited support during major international health crises such as the successive famines in East Africa. By the late 1980s, Eastern Europeans forfeited their alternative medical modernity as they embraced Western-inspired privatization and abandoned their pioneering role in public healthcare in the developing world.

This chapter argues that the League of Nations’ authority in interwar politics rested to a large extent on transnational and (post-) imperial practices from Eastern and Central Europe which were established in the context of wider geopolitical constellations. Agents from the former Habsburg and Russian empires, working as experts and officers in the Secretariat and the many commissions, are instructive in this regard. They used their mobilities, networks, and practices of internationalism from the prewar imperial era to shape the League’s outreach and brought issues of the post-imperial transformations in their region to the League’s agenda. This East Central European legacy will be shown by portraying two individuals, Ludwik Rajchman, director of the League’s Health Organization and Albert Apponyi, who served as a delegate and expert on issues such as disarmament and intellectual cooperation. Their biographies highlight the variety and transformative power of participation from East Central Europe in the League and show the organization as a polycentric body. Besides, internationalism in the post-First World War period comes out as permeated by different imperial pasts, post-imperial undercurrents, and transnational dynamics.

This brief presents social and political considerations for the design and implementation of vaccination-related risk communication and community engagement (RCCE) strategies for mpox in the eastern Democratic Republic of the Congo (DRC). A nationwide outbreak of mpox (clade I) was declared in late 2022 and now affects 23 of its 26 provinces. Notably, the outbreak is characterised by widespread human-to-human transmission unlike previous outbreaks primarily involving animal-human contact. While mpox hotspots are emerging around the country, this brief focuses on eastern DRC where complex political history and ongoing armed conflict – on top of poor infrastructure and rural isolation of many communities – present significant challenges. These challenges demand carefully designed and tailored strategies. Furthermore, a mutated, more virulent mpox strain has also emerged in the eastern province of South Kivu. Although little remains known about transmission dynamics in the outbreak overall, sexual transmission of the new strain is of concern, putting stigmatised populations such as sex workers and others at risk. Overall, however, children are the most affected population, with transmission driven by close physical contact. Along with pregnant women and people with compromised immunity (e.g., people with HIV/AIDS), children are also at higher risk of complications and death. The World Health Organization (WHO) recommends targeted vaccination approaches in the context of mpox outbreaks, including as postexposure prophylaxis for these populations. The DRC Ministry of Public Health has announced intentions to vaccinate both children and adults with the LC16 and MVA-BN mpox vaccines, respectively, under a temporary emergency use authorisation as these vaccines are not yet approved in the country. Efforts are now mobilising to design vaccine and related RCCE interventions. This brief draws on a SSHAP roundtable discussion on mpox in the DRC (May 2024), consultation with social science experts and health and humanitarian actors active in or knowledgeable about the region and outbreak, and academic and grey literature.