Monkeypox (mpox) is a new problem on a global scale for humanity.

Purpose - to draw attention to an infection that was little known, but has now become a global problem for society;to familiarize readers with the peculiarities of the 2022 monkeypox outbreak and to increase the level of alertness of doctors to this disease. Monkeypox is a global problem because the disease is spreading rapidly, covering 111 countries. Three cases were diagnosed in Ukraine. It is predominantly a self-limited infection, but there are severe and deadly complications. The lethality of this disease ranges from 0% to 11%. The course of the disease is more severe in children and people with reduced immunity. Vertical transmission of the virus from mother to child is possible, resulting in congenital monkeypox. Monkeypox is a zoonotic disease and its natural reservoir is not exactly known, but rodents are most likely to act. In most cases, person-to-person transmission of the virus occurs through close skin to skin contact, often during sexual intercourse. At the beginning of the outbreak 98% of cases of disease were was diagnosed in homo- and bisexuals. Airborne transmission is also possible. Infection is possible through close contact with infectious skin lesions. Clinically, the initial period resembles influenza, but lymphadenopathy is characteristic, which is considered a pathognomonic symptom of mpox. The rash is similar to that of chickenpox, but with more prevalent location on palms and soles than in chickenpox. In the presence of a vesicular rash in a patient, it is necessary to exclude monkeypox. PCR diagnostics of the virus in samples of vesicles or crusts has the greatest diagnostic value. Hygienic skin care is important. Antiviral drugs (tecovirimat, brincidofovir) are recommended only in severe cases. To reduce the spread of infection, international rules apply as for other infections, such as COVID-19. The monkeypox virus vaccine is recommended primarily for groups at risk of infection, including medical personnel who may come into contact with the patient or samples for laboratory testing. Being aware for this infection, following international health regulations, it is possible to prevent the further spread of monkeypox.Copyright © 2023 Tomsk State University. All rights reserved.

Public Health Events' Assessment Per Annex-2 Decision- Instrument of the Ihr (2005) and Communication with the World Health Organization's Ihr State Parties in the Who European-Region

Intro: Guided by the annex-2 decision instrument of the International Health Regulations (IHR) 2005, public health events are assessed and notified to WHO by the IHR State Parties. Similarly, using the secure Event Information Site (EIS), the WHO shares information with the IHR State Parties through their National Focal Points (NFPs). This summarizes information about such events associated with the WHO European Region (EURO). Method(s): From the EIS, a list of events that may constitute a public health emergency of international concern shared by the WHO with the NFPs was extracted. This descriptive analysis includes data from 2007-2022 within the European Region or travel-associated while events occurred elsewhere. Finding(s): Of all the events (from six WHO Regions), 15% were associated with the European Region. The annual proportion varied such as 8% in 2007 and 22% in 2022. Events' classification by hazards and syndromes showed infectious (89%) and acute respiratory syndromes (42%) as the most common causes. Per annex-2 of the IHR (2005), about 88% and 66% of events qualified for unusual/unexpected or serious public health impact respectively and 60% simultaneously qualified both the criteria. About 61% of events qualified for unusual/unexpected and having risk of international spread concurrently. Similarly, 55% events had risk of international spread and serious public health impact, simultaneously. About 16% had risk of interference with international travel/trade. The recent EIS communications (2019-2022) were related to monkeypox, COVID-19, hepatitis of unknown aetiology, human influenza caused by a new subtype and polio. Conclusion(s): The events' assessment shared with the NFPs through the secure EIS platform is promptly accessible to all the IHR State Parties. Over the past fifteen years, such communications can improve situational awareness of events and facilitate information exchange for IHR State-Parties. Moreover, this encourages handling hazards at their source and strengthen readiness and response.Copyright © 2023

Universal health coverage mitigated COVID-19 health-related consequences in Asia Oceania.

The COVID-19 pandemic has been a continual challenge since 2020, and it continues to impact people and industries as a disaster caused by a biological hazard. This study examined universal health coverage (UHC) scores in relation to the performance in combating COVID-19 in the Southeast Asian region (SEAR) and the Western Pacific region (WPR), along with the State Party Self-Assessment Annual Reporting (SPAR) index under the international health regulations (IHC). The numbers of infections and deaths per million population from December 2019 to June 2022 were used as primary outcomes to measure countries' performance. Countries with UHC scores of 63 or higher had a significantly lower number of infected patients and deaths. In addition, several inter-capacity correlations within the SPAR capacities, including with C8 (the National Health Emergency Framework), as well as a very strong correlation to C4 (Food Safety), C5 (Laboratory), and C7 (Human Resources). Furthermore, C9 (Health Service Provisions) has a very strong correlation to C1 (Legislation and Financing), C2 (International Health Regulation Coordination and a National IHR Focal Point function), and C4 (Food Safety), suggesting that the capability to manage an emerging infectious disease form blocks of capacities. In conclusion, UHC clearly mitigated the health-related consequences of COVID-19 in South-East Asia Region (SEAR) and Western Pacific Region (WPR). Investigating the correlation between the SPAR capacities and UHC is a promising approach for future research, including the importance of the provision of health services, points of entry, and, most importantly, risk communications as critical factors for managing pandemic. This study constitutes a good opportunity to apply the SPAR index to define which capacities correlate with the outcome of the pandemic in terms of infections and deaths.

Severe Acute Hepatitis in Children

Viral infections affecting the liver had a serious impact on humanity, as they have led to significant morbidity and mortality in patients with acute and chronic infections. The discovery of the viral agents of severe acute hepatitis in children triggered interest of the scientific community to establish the pathogenesis and diagnostic techniques to identify the affected population. But, WHO, together with scientists in various affected countries, are working to understand the cause of this infection that does not appear to belong to any of the known five types of hepatitis viruses: A, B, C, D and E. Many cases of severe acute hepatitis of unknown origin in children <10 years of age were reported by the International Health Regulations (IHR) was mainly by adenovirus infection, HAdV-41. Although most acute infections cause mild disease and even go undetected, some can lead to complications and turn fatal. With the rapid scientific and technological advances in the last centuries, controlling and even curing the infections became a possibility, with a large focus on preventive medicine through vaccination. The review article describes the epidemiology, pathogenesis, clinical presentation, diagnostic tools and current medication regimens for severe acute hepatitis of unknown origin in children.Copyright © 2022, Global Research Online. All rights reserved.

Assessing core capacities for addressing public health emergencies of international concern at designated points of entry in cameroon during the COVID-19 Pandemic.

BACKGROUND: Points of Entry (POEs) are at the frontline for prevention, detection and response to international spread of diseases. The objective of this assessment was to ascertain the current level of existing International Health Regulations (IHR) core capacities of designated airports, ports and ground crossings in Cameroon and identify critical gaps for capacity building for prevention, early warning and response to public health threats including COVID-19. METHODS: Data were collected from April to May 2020 in 5 designated POEs: Yaounde Nsimalen International Airport (YIA), Douala international Airport (DIA), Douala Autonomous Port (DAP), Garoua-Boulai ground crossing, Kye-Ossi ground crossing which were all selected for their high volume of passenger and goods traffic. The World Health Organization (WHO) assessment tool for core capacity requirements at designated airports, ports and ground crossings was used to collect data on three technical capacities: (i) communication and coordination, (ii) Capacities at all times and (iii) capacities to respond to Public Health Emergencies of International Concern (PHEIC). RESULTS: All the investigated POEs scored below 50% of capacities in place. YIA recorded the highest percentage for all groups of capacities, coordination and communication and for core capacity at all times with a percentage of 42%, 58% and 32% respectively. For core capacity to respond to PHEIC, all the POEs recorded below 50%. The DAP and all ground crossings lacked trained personnel for inspection of conveyances. Only DIA had a public health emergency plan. There is no isolation/quarantine and transport capacity at the POEs. CONCLUSION: All POEs assessed did not meet IHR standards and need significant improvement to fulfill the IHR requirements. Unstructured communication channels between stakeholders make the implementation of IHR challenging. A coordination mechanism, with clear functions and structure, is necessary for well-coordinated response efforts to health emergencies at POEs. This assessment will serve as a baseline to inform planning and IHR implementation at designated POEs in Cameroon.

The contribution of legal determinants to strengthening health security in Africa

Introduction/ Background: The proliferation of legal instruments in the management of Covid-19 in Africa reinforced the need of holistic health systems reforms based on compliance with the International Health Regulations (IHR 2005) that question the capacity and contribution of legal frameworks to support preparedness and response to public health emergencies in Africa. Methods: The study targets all the 55 countries of African Union from August to December 2021.We analysed the technical area related to legislation, policies and financing in the reports of the Joint External Evaluation of the International Health Regulation capacities as well as the Performance of Veterinary Services assessment reports in these countries. The annual reports on IHR implementation from 2018 to 2020 and the Covid-19 management evaluation reports in these countries were analysed. Results: 47/55 African Union countries have completed the joint external evaluation of IHR capacity. In most of the African Union countries, capacities for health emergency preparedness and response regarding legislation and policies are weak , multi-sectoral assessment is recommended, as well as establishment of legal epidemiology and health security policies surveillance. The 2020 annual report on IHR implementation in the WHO African Region show that the average score for legislation (47%) was lower than that of the WHO regions as a whole (68%). Few African Union countries have conducted partial evaluations of their legislation under the Animal Health Organisation's Veterinary Legislation Support Programme. Impact: The coherence and consistency of legal frameworks affect the performance of national public health emergency preparedness and response systems. The assessment and updating of national legal frameworks for public health emergency management is a major challenge for public health security in Africa. Conclusion: The provision of an effective legal frameworks for health security is lacking in most of the African Union state members , even though it is a crucial tool for public health.

GLOBAL HEALTH GOVERNANCE IN PANDEMIC PREPAREDNESS AT WORLD HEALTH ORGANIZATION. TOPICS AND FORTHCOMING DEBATES

COVID-19 pandemic has shown the flaws in global health governance, regarding pandemic preparedness. Instead of attaining to International Health Regulations (IHR), revised in 2005 at World Health Organization (WHO), every country has instrumented its own rules to control the spread of SARSCoV2. Nationalistic positions have prevailed, concerning access to medical technologies (such as vaccines, diagnostics or medicines), or quarantines blocking trade and free circulation. The fragmentation in global health governance is very evident. This has been a consequence of the diminished role of WHO, due to its budgetary limits. These constraints have limited the role of WHO to respond in a coordinated way during COVID-19 pandemic. New pandemics have been forecasted during this century, as a result of changes in the relationship between humans with our environment. Thus, coordination in global health governance is needed. In December 2021, the resolution 74.7 of World Health Assembly (WHA) has ordered the creation of a Commission, which will review international health governance, regarding pandemics preparedness. Through a review of the legal framework, this presentation aims to unfold the possibilities for the new governance -either by amending IHR, creating a new instrument, or a combination of both (for example, the creation of a Framework to respond to subsequent pandemics, such as the one devoted for influenza)-, as well as the topics revisited (i.e. benefit- sharing of pathogens, equitable production and distribution of medical technologies, or the creation of a dispute resolution mechanism). Some themes will be hotly debated between North and South. Additionally, WHO doesn't hold exclusive jurisdiction in some of the topics, as far as they're regulated by other international forums.

Pandemic response and international law: The case of COVID-19

The coronavirus pandemic is currently raging throughout the world. The ensuing crisis has acquired a multidimensional nature, affecting all levels of society, including international health legal order. For international health law, the World Health Organization (WHO) is the international institution with a core mandate in issues of global health. Moreover, the International Health Regulations (IHR) is the main legally binding instrument laying down rules for the cross-border spread of contagious diseases. Against this backdrop, this paper evaluates the issues and disputes under the current regimes of international health law. The paper then offers some thoughts by way of answers to the research questions.

Fighting against the common enemy of COVID-19: a practice of building a community with a shared future for mankind.

The outbreak of coronavirus disease 2019 (COVID-19) has caused more than 80 813 confirmed cases in all provinces of China, and 21 110 cases reported in 93 countries of six continents as of 7 March 2020 since middle December 2019. Due to biological nature of the novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with faster spreading and unknown transmission pattern, it makes us in a difficulty position to contain the disease transmission globally. To date, we have found it is one of the greatest challenges to human beings in fighting against COVID-19 in the history, because SARS-CoV-2 is different from SARS-CoV and MERS-CoV in terms of biological features and transmissibility, and also found the containment strategies including the non-pharmaceutical public health measures implemented in China are effective and successful. In order to prevent a potential pandemic-level outbreak of COVID-19, we, as a community of shared future for mankind, recommend for all international leaders to support preparedness in low and middle income countries especially, take strong global interventions by using old approaches or new tools, mobilize global resources to equip hospital facilities and supplies to protect noisome infections and to provide personal protective tools such as facemask to general population, and quickly initiate research projects on drug and vaccine development. We also recommend for the international community to develop better coordination, cooperation, and strong solidarity in the joint efforts of fighting against COVID-19 spreading recommended by the joint mission report of the WHO-China experts, against violating the International Health Regulation (WHO, 2005), and against stigmatization, in order to eventually win the battle against our common enemy - COVID-19.