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Pneumonia is the leading cause of morbidity and mortality in children younger than 5 years. Vaccines are available against the main bacterial pathogens Haemophilus influenzae type b and Streptococcus pneumoniae . There are also vaccines against measles and pertussis; diseases that can predispose a child to pneumonia. Partners such as the Global Alliance for Vaccines and Immunisation (GAVI), the Hib Initiative, the Accelerated Development and Introduction Plan for pneumococcal vaccines and the Measles Initiative, have accelerated the introduction of vaccines into developing countries. Whilst significant improvements in vaccine coverage have occurred globally over the past decade, there still remains an urgent need to scale-up key pneumonia protection and treatment interventions as identified in the Global Action Plan for the Prevention and Control of Pneumonia (GAPP). There is promise that global immunisation will continue to improve child survival. However, there are several challenges to vaccine implementation that must first be addressed, including: a lack of access to under-served and marginalised populations; inadequate planning and management; a lack of political commitment; weak monitoring and surveillance programmes and assured sustainable finance and supply of quality vaccines. There is an urgent need to increase global awareness of the devastation that pneumonia brings to the worlds poorest communities.

Background The World Health Organization developed the Global Action Plan on Antimicrobial resistance (AMR) as a priority because of the increasing threat posed to human health, animal health and agriculture. Countries around the world have been encouraged to develop their own National Action Plans (NAPs) to help combat AMR. The objective of this review was to assess the content of the NAPs and determine alignment with the Global Action Plan on Antimicrobial Resistance using a policy analysis approach. Body National Action Plans were accessed from the WHO Library and systematically analysed using a policy analysis approach for actors, process, context and content. Information was assessed using a ‘traffic light’ system to determine agreeance with the five WHO Global Action Plans objectives. A total of 78 NAPs (70 WHO approved, eight not approved) from the five global regions were analysed. National action plans which provided more information regarding the consultative process and the current situation regarding AMR allowed greater insight to capabilities of the country. Despite the availability of guidelines to inform the development of the plans, there were many differences between plans with the content of information provided. High income countries indicated greater progression with objectives achievement while low and middle-income countries presented the need for human and financial resources. Conclusion The national action plans provide an overview of activities underway to combat AMR globally. This analysis reveals how disconnected the process has been and how little information is being gathered globally.

Antimicrobial resistance (AMR) continues to pose a significant public health problem in terms of mortality and economic loss. Health authorities of several countries including India have formulated action plans for its containment. In this fight against AMR, it is important to realize the contribution by all the following four spheres: humans, animals, food and environment. This review incorporates all the spheres of One Health concept from the Indian perspective. India has one of the highest rates of resistance to antimicrobial agents used both in humans and food animals. The environment, especially the water bodies, have also reported the presence of resistant organisms or their genes. Specific socio-economic and cultural factors prevalent in India make the containment of resistance more challenging. Injudicious use of antimicrobials and inadequate treatment of waste waters are important drivers of AMR in India. Use of sludge in agriculture, improper discard of livestock animals and aquaculture industry are considered AMR contributors in other countries but Indian data regarding these are lacking. Efforts to combat AMR have been initiated by the Indian health authorities but are still at preliminary stages. Keeping in view the challenges unique to India, future directions are proposed.

Background Antimicrobial resistance (AMR) is a growing problem worldwide in need of global coordinated action. With the endorsement of the Global Action Plan (GAP) on AMR in 2015, the 194 member states of the World Health Organization committed to integrating the five objectives and corresponding actions of the GAP into national action plans (NAPs) on AMR. The article analyzes patterns of alignment between existing NAPs and the GAP, bringing to the fore new methodologies for exploring the relationship between globally driven health policies and activities at the national level, taking income, geography and governance factors into account. Methods The article investigates the global governance of AMR. Concretely, two proxies are devised to measure vertical and horizontal alignment between the GAP and existing NAPs: (i) a syntactic indicator measuring the degree of verbatim overlap between the GAP and the NAPs; and (ii) a content indicator measuring the extent to which the objectives and corresponding actions outlined in the GAP are addressed in the NAPs. Vertical alignment is measured by the extent to which each NAP overlaps with the GAP. Horizontal alignment is explored by measuring the degree to which NAPs overlap with other NAPs across regions and income groups. In addition, NAP implementation is explored using the Global Database for Antimicrobial Resistance Country Self-Assessment. Findings We find strong evidence of vertical alignment, particularly among low-income countries and lower-middle-income countries but weaker evidence of horizontal alignment within regions. In general, we find the NAPs in our sample to be mostly aligned with the GAP’s five overarching objectives while only moderately aligned with the recommended corresponding actions. Furthermore, we see several cases of what can be termed ‘isomorphic mimicry’, characterized by strong alignment in the policies outlined but much lower levels of alignment in terms of actual implemented policies. Conclusion To strengthen the alignment of national AMR policies, we recommend global governance initiatives based on individualized responsibilities some of which should be legally binding. Our study provides limited evidence of horizontal alignment within regions, which implies that regional governance institutions (e.g., WHO regional offices) should primarily act as mediators between global and local demands to strengthen a global governance regime that minimizes policy fragmentation and mimicry behavior across member states.

The high burden of communicable diseases in African countries engenders extensive antimicrobial use and subsequent resistance with substantial health, financial and societal implications. A desktop analysis to ascertain whether countries in the WHO African region have implemented the WHO Policy Package to combat antimicrobial resistance (AMR) revealed that just two countries (4.3%) have national AMR plans in place, 14.9% (7) have overarching national infection prevention and control (IPC) policies, 93.6% (44) have essential medicines lists and 91.5% (43) have national medicines policies and treatment guidelines intimating rational use. None currently have representative national surveillance systems nor do any incentivize research and development into new medicines and diagnostics. A regional situational analysis to identify scalable good practices within African, resource-constrained country contexts under the auspices of WHO-AFRO is a necessary initial step towards the development of national and regional action plans in concert with incremental progress towards achieving the objectives of the policy package and global action plan. While it is clearly the responsibility of governments to develop, resource and implement plans, regular reporting to and/or monitoring and evaluation by an overarching body such as WHO-AFRO will ensure persistent incremental progress within continuous quality and accountability improvement paradigms.

To prevent and reduce inactivity, the World Health Organization (WHO) designed a global plan called Global Action Plan on Physical Activity 2018–2030 (GAPPA) in 2017. In this plan and according to the state of physical activity in 2016, actions and goals were set. However, the world is facing a COVID-19 pandemic, which has affected various aspects of lifestyle, including physical activity. Some studies have shown that physical activity reduced during the pandemic. For this reason, the WHO should review the GAPPA and update goals and actions according to the state of physical activity in 2020.

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