Bulletin of the World Health Organization最新文献

{"title":"Fundamental changes in regulation to improve access to biosimilars.","authors":"Hye-Na Kang, Ivana Knezevic, Meenu Wadhwa, Eun Kyung Kim","doi":"10.2471/BLT.25.294908","DOIUrl":"10.2471/BLT.25.294908","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 7","pages":"517-521"},"PeriodicalIF":6.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for standardized tracking of investments in digital health.","authors":"Kirsten M Mathieson, Mathilde Forslund","doi":"10.2471/BLT.25.293752","DOIUrl":"10.2471/BLT.25.293752","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 7","pages":"522-524"},"PeriodicalIF":6.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public health round-up.","authors":"","doi":"10.2471/BLT.26.010726","DOIUrl":"https://doi.org/10.2471/BLT.26.010726","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 7","pages":"443-444"},"PeriodicalIF":6.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diplomatic roles of regional coordinators for WHO Member States.","authors":"Nikica Daraboš, Monica Stanovic, Danira Matijaca","doi":"10.2471/BLT.25.294847","DOIUrl":"10.2471/BLT.25.294847","url":null,"abstract":"<p><strong>Objective: </strong>To examine the coordination functions, decision-making processes and consensus-building strategies of World Health Organization (WHO) regional coordinators of Member States in Geneva within the WHO's federal governance structure.</p><p><strong>Methods: </strong>In this qualitative study, we interviewed 12 current and former regional coordinators from five WHO regions (African, the Americas, South-East Asia, European and Eastern Mediterranean) using a semi-structured questionnaire. A regional coordinator from the Western Pacific Region later provided a written response to the questionnaire which we report separately due to methodological and time differences. We analysed the data using a hybrid thematic approach combining initial coding assisted by artificial intelligence with our rigorous interpretive validation.</p><p><strong>Findings: </strong>We identified eight main coordination functions. Core liaison and information-sharing were functions undertaken by regional coordinators in all the regions, while position development and meeting organization were undertaken by regional coordinators in most regions. Coordination complexity and consensus-building strategies, such as bilateral mediation and issue reframing, varied depending on regional political dynamics and institutional capacities. A formal job description and procedural handbooks were lacking, and therefore the regional coordinator role was a negotiated practice dependent on informal knowledge transfer.</p><p><strong>Conclusion: </strong>Regional coordinators serve as boundary-spanners linking regional autonomous governance with global health governance. To address the absence of documented institutional knowledge, we propose developing formal induction curricula, cross-regional mentorship pairing and harmonized procedural handbooks. These measures will strengthen regional voices and ensure more inclusive participation in global health diplomacy.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 7","pages":"445-453"},"PeriodicalIF":6.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148367214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An umbrella protocol for the clinical evaluation of diagnostics in infectious disease.","authors":"Edward Blandford, Sarah Tunkel, Elizabeth Coates, Carolina R Arevalo, Simon E Kolstoe, Obaghe Edeghere, Fiona Maleady-Crowe, David Chapman, Carolyn Lewis, Raghavendran Kulasegaran-Shylini, Richard Vipond, Deborah A Williamson, Richard Pebody, Isabel Oliver, Susan Hopkins, Sue Hill, Tom Fowler","doi":"10.2471/BLT.25.293246","DOIUrl":"10.2471/BLT.25.293246","url":null,"abstract":"<p><p>Umbrella protocols have recently come to be widely used in clinical trial designs. However, the value of this approach in public health is less well recognized. The coronavirus disease 2019 (COVID-19) pandemic highlighted the need for rapid, reliable and scalable evaluation of diagnostic technologies. In the United Kingdom of Great Britain and Northern Ireland, this need prompted the development of an umbrella research protocol enabling multiple clinical evaluation studies of similar designs to be undertaken under a single overarching preapproved ethics and governance framework. We describe the development, implementation and evolution of this protocol, which was designed to support timely assessment of the performance of in vitro diagnostic devices and associated testing approaches in various settings. The umbrella protocol allowed studies to be started quickly during the pandemic, reduced administrative burdens, supported regulatory submissions and enabled prospective collection of samples for surveillance. While the system described reflects British governance structures, the principles underpinning this approach, including proportionality (ensuring oversight requirements are appropriate to the risk level), standardization and preapproved flexibility, are applicable to many settings. The protocol now forms part of the United Kingdom's wider pandemic preparedness structure and illustrates how preapproved, adaptable research frameworks can accelerate evidence generation during outbreaks. The world is now assessing lessons from the COVID-19 pandemic and it is timely to consider how research systems can support innovative designs such as umbrella protocols. We therefore summarize lessons learnt and practical considerations to support other countries seeking to adopt similar approaches within their own ethical and regulatory systems.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 7","pages":"495-504"},"PeriodicalIF":6.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13318375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public health round-up.","authors":"","doi":"10.2471/BLT.26.010626","DOIUrl":"https://doi.org/10.2471/BLT.26.010626","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 6","pages":"372-373"},"PeriodicalIF":5.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and neonatal outcomes in a cohort of pregnant women during conflict, Gaza Strip.","authors":"Zeina Jamaluddine, Reham Jaffal, Sanaa Al Najjar, Mahmoud Al Kahlout, Tamam Abu Zeid, Hala Mughari, Ghada Al Jadba, Rami Habash, Bassam A Abu Hamad, Akihiro Seita, Oona Maeve Renee Campbell","doi":"10.2471/BLT.25.293829","DOIUrl":"10.2471/BLT.25.293829","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of conflict on maternal and neonatal mortality and health-care utilization among pregnant refugee women in the Gaza Strip.</p><p><strong>Methods: </strong>The study involved data on pregnancy outcomes for 17 713 refugee women in the Gaza Strip who were pregnant on 8 October 2023 and received antenatal care from the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). We obtained data from UNRWA's electronic health records, an UNRWA phone survey and the Palestinian Ministry of Health's lists of deaths for October 2023 to June 2024.</p><p><strong>Findings: </strong>Overall, 168 maternal deaths were identified, yielding a pregnancy-related mortality ratio of 948 per 100 000 pregnancies compared to a maternal mortality ratio of 30 per 100 000 live births before the conflict. The pattern of age-specific, pregnancy-related deaths suggested that most were trauma-related. The stillbirth rate among women with known pregnancy outcomes was 10.3 per 1000 births compared with 6.0 per 1000 before the conflict, and the neonatal mortality rate was 9.4 per 1000 live births compared with 6.6 per 1000. The preterm birth rate was also higher, at 13.6% versus 9.7% before the conflict. Although most deliveries (97.3%) remained facility-based, there was a shift from government to nongovernmental organization facilities.</p><p><strong>Conclusion: </strong>The conflict in the Gaza Strip was associated with substantial increases in maternal and neonatal mortality and preterm births. Utilization of health services remained high, but delivery locations shifted to lower-level facilities and hospital stays shortened, raising concerns about the quality of care.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 6","pages":"386-395"},"PeriodicalIF":6.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost of adapting the International Guide for Monitoring Child Development, Guatemala and India.","authors":"Scott Tschida, Anuj Mundra, Revan Mustafa, Amruta Bandal, Magdalena Guarchaj, Karyn Choy, Priyamvada Das, Sara Hernandez, Ashwini Kalantri, Abhishek V Raut, Anushree Sane, Roopa Srinivasan, Vibha Krishnamurthy, Ilgi Ertem, Subodh S Gupta, Peter Rohloff, Chunling Lu","doi":"10.2471/BLT.25.294361","DOIUrl":"10.2471/BLT.25.294361","url":null,"abstract":"<p><strong>Objective: </strong>To assess the cost of co-creating an adaptation of the International Guide for Monitoring Child Development (intervention for use by community health workers (CHWs)) in rural Guatemala and India.</p><p><strong>Methods: </strong>We developed survey instruments to capture the costs, from health-system and societal perspectives, of adapting the guide with local partners and international experts in the two sites. We included the costs of human resources, information technology, and infrastructure and logistic support. To improve the transparency and comparability of cost estimates, we reported the required resources for adaptation, such as time and expertise of human resources, and the quantity, function and usage time of the resources used.</p><p><strong>Findings: </strong>Adaptation of the guide took 14 months in India and 18 months in Guatemala during 2021-2022. Total costs by site were 38 174.57 United States dollars (US$) in Guatemala, US$ 39 287.15 in India and US$ 81 846.59 for international consultants. International consultants accounted for about half of the costs, and the Guatemala and India sites each accounted for about a quarter of the costs. Human resources were the largest contributor to the adaptation costs in both sites (90.1%; 34 398.20/38 174.57 in Guatemala and 94.8%; 37 262.74/39 287.15 in India) followed by infrastructure support and information technology.</p><p><strong>Conclusion: </strong>Since most of the required steps to adapt the guide for use by CHWs have now been done by our study, we expect future adaptation costs to be lower. The methods used in this study provide an example of how to cost intervention adaptations in the future.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 6","pages":"396-406"},"PeriodicalIF":6.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Governance of artificial intelligence for health systems, WHO European Region.","authors":"Keyrellous Adib, Nicholas Letchford, Hanna Emilia Dunning, Nagui Salama, Yiannos Tolias, Jerome De Barros, Natasha Azzopardi-Muscat, Hans Henri P Kluge, David Novillo-Ortiz","doi":"10.2471/BLT.25.294978","DOIUrl":"10.2471/BLT.25.294978","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview of the status of artificial intelligence (AI) governance for health in the World Health Organization (WHO) European Region.</p><p><strong>Methods: </strong>The WHO Regional Office for Europe developed a cross-sectional survey on AI governance and adoption. The survey was available to all 53 Member States between June 2024 and March 2025. Responses were analysed at the regional and subregional level.</p><p><strong>Findings: </strong>Of the 50 Member States responding to the survey, 8% (4/50) have a health-specific AI strategy and 14% (7) are developing one. Regionally, 33 Member States have implemented cross-sectoral AI strategies and 8 (16%) are developing them. Of these Member States, almost half each have assigned implementation and oversight responsibilities to existing single or multiple government agencies. Nearly half the Member States (23) reported ongoing assessments of laws and policies on AI systems and a fifth (10) have developed new health-specific AI laws. Only 14 Member States have issued guidelines to address the ethical implications of using AI in health or across sectors. Less than 10% (4) of Member States have developed liability standards for AI or guidance on the application of existing liability standards. Overall, 33 (66%) Member States have adopted health data strategies, 33 (66%) have health data hubs and (68%) have health data authorities supporting data access and control.</p><p><strong>Conclusion: </strong>In the WHO European Region, governance of AI in health care is underdeveloped. Adaptive legal and policy mechanisms are needed to respond effectively to the complex and evolving challenges of AI integration in health systems.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 6","pages":"374-385"},"PeriodicalIF":6.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic priorities in the global action plan for wasting: Burkina Faso, Ethiopia, Kenya and Malawi.","authors":"Adriana Newman, Indi Trehan, Tessema Masresha, Kenneth M Maleta, Hama A Diallo, Moses Ngari, Daniel Muhinja, Kirkby D Tickell","doi":"10.2471/BLT.25.293259","DOIUrl":"10.2471/BLT.25.293259","url":null,"abstract":"<p><p>Shifts in global aid funding threaten the sustainability of programmes addressing childhood wasting and population-based surveys used to inform their geographic targeting. Re-evaluating how priority regions are identified is essential to ensure constrained resources reach the greatest number of affected children. We examined how the <i>Global action plan on child wasting</i> prioritization strategies aligned with the geographic distribution of childhood wasting in four countries: Burkina Faso, Ethiopia, Kenya and Malawi. We used the two most recent Demographic and Health Surveys of each country to estimate the annual absolute burden of wasting in global action plan priority and non-priority areas. Prioritized areas consistently captured the highest wasting prevalence and, except in Kenya, experienced larger reductions in wasting prevalence over time. However, in Burkina Faso, Kenya and Malawi, between 43.6% (142 631/327 349) and 69.8% (992 370/1 422 301) of children with wasting lived in non-priority areas, largely in more populous regions with a lower prevalence of wasting but a high absolute burden. These findings highlight a key limitation of prevalence-based prioritization: low-prevalence areas can contain numerous affected children if they are more densely populated. While prevalence-based targeting has successfully delivered nutritional services to millions of children, targets of the global action plan and sustainable development goals are unlikely to be met without addressing the burden of wasting in non-priority areas. With global nutrition financing increasingly constrained, countries must adapt data systems to enable flexible prioritization that balances prevalence and burden, while implementing context-adapted strategies to cost-effectively expand coverage where the largest numbers of affected children live.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 6","pages":"417-426"},"PeriodicalIF":6.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13234262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}