Abbreviated Report of the WHO Western Pacific Region Workshop on National Plans of Action for Nutrition: Key Elements for Success, Constraints and Future Plans

A workshop on National Plans of Action for Nutrition: Constraints, Key Elements for Success, and Future Plans was convened and organized by the WHO Regional Office for the Western Pacific in collaboration with the Institute for Medical Research Malaysia and co sponsored with FAO and UNICEF from 25—29 October 1999. It was attended by representatives of 25 countries in the region and resource persons, representatives from WHO and other international agencies. The objectives of the workshop were to review the progress of countries in developing, implementing and monitoring national plans of action for nutrition (NPANs) in the Western Pacific Region and to identify constraints and key elements of success in these efforts. Most of the countries have NPANs, either approved and implemented or awaiting official endorsement. The Plan formulation is usually multisectoral, involving several government ministries, non governmental organizations, and international agencies. Often official adoption or endorsement of the Plan comes from the head of state and cabinet or the minister of health, one to six years from the start of its formulation. The NPAN has stimulated support for the development and implementation of nutrition projects and activities, with comparatively greater involvement of and more support from government ministries, UN agencies and non-governmental agencies compared to local communities, bilateral and private sectors and research and academic institutions. Monitoring and evaluation are important components of NPANs. They are, however, not given high priority and often not built into the plan. The role of an intersectoral coordinating body is considered crucial to a country's nutrition program. Most countries have an intersectoral structure or coordinating body to ensure the proper implementation, monitoring and evaluation of their NPANs. The workshop identified the constraints and key elements of success in each of the four stages of the NPAN process: development, operationalization, implementation, and monitoring and evaluation. Constraints to the NPAN process relate to the political and socioeconomic environment, resource scarcity, control and management processes, and factors related to sustainability. The group's review of NPAN identified successful NPANs as those based on recent, adequate and good quality information on the nutritional situation of the country, and on the selection of strategies, priorities and interventions that are relevant to the country and backed up by adequate resources. Continued high level political commitment, a multisectoral approach, and adequate participation of local communities are other key elements for success. The participants agreed on future actions and support needed from various sources for the further development, implementation, monitoring and evaluation of their NPANs. The recommendations for future actions were categorized into actions pertaining to countries with working NPAN, actions for countries without working NPAN and actions relevant to all countries. There was also a set of suggested actions at the regional level, such as holding of regular regional NPAN evaluation meetings, inclusion of NPAN on the agenda of regional fora by the regional organizations, and strengthening of regional nutrition networks.

Burden of mental disorders and risk factors in the Western Pacific region from 1990 to 2021

BACKGROUND The burden of mental disorders(MD)in the Western Pacific Region(WPR)re-mains a critical public health concern,with substantial variations across demogra-phics and countries.AIM To analyze the burden of MD in the WPR from 1990 to 2021,along with associated risk factors,to reveal changing trends and emerging challenges.METHODS We used data from the Global Burden of Disease 2021,analyzing prevalence,incidence,and disability-adjusted life years(DALYs)of MD from 1990 to 2021.Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.RESULTS Between 1990 and 2021,the prevalence of MD rose from 174.40 million cases[95%uncertainty interval(UI):160.17-189.84]to 234.90 million cases(95%UI:219.04-252.50),with corresponding DALYs increasing from 22.8 million(95%UI:17.22-28.79)to 32.07 million(95%UI:24.50-40.68).During this period,the burden of MD shifted towards older age groups.Depressive and anxiety disorders were predominant,with females showing higher DALYs for depressive and anxiety disorders,and males more affected by conduct disorders,attention-deficit hyperactivity disorder,and autism spectrum disorders.Australia,New Zealand,and Malaysia reported the highest burdens,whereas Vietnam,China,and Brunei Darussalam reported the lowest.Additionally,childhood sexual abuse and bullying,and intimate partner violence emerged as significant risk factors.CONCLUSION This study highlights the significant burden of MD in the WPR,with variations by age,gender,and nation.The coronavirus disease 2019 pandemic has exacerbated the situation,emphasizing the need for a coordinated response.

Urgent needs in fostering neglected tropical diseases(NTDs)laboratory capacity in WHO Western Pacific Region:results from the external quality assessment on NTDs diagnosis in 2012-2015

Background:Neglected tropical diseases(NTDs)are a heterogeneous group of mainly chronic,debilitating and often stigmatizing diseases that largely affects low-income and politically marginalized populations,causing a large burden of public health,social and economies in the NTDs endemic countries.NTDs are caused by infections with a range of pathogen,including bacteria,parasites,protozoa and viruses.The accurate diagnosis of NTDs is important for reducing morbidity,preventing mortality and for monitoring of control programs.External Quality Assessment(EQA),a component of laboratory quality assurance,aims to assess the performance of participating laboratories in detecting parasitic infections.The aim of this paper is to report the findings and put forward the recommendations on capacity build from the EQA results of participating NTDs laboratories in selected countries in the WHO Western Pacific Region from 2012 to 2015.Methods:Reference or public health laboratories at national level working on NTDs in 6 countries participated in EQAs organized by the National Institute of Parasitic Diseases(NIPD)of Chinese Center for Disease Control and Prevention(CDC)based in Shanghai,China.Two representatives of each participating laboratory were invited to NIPD to detect NTDs’parasitic infections using the same prepared samples for serological tests(IHA and ELISA)and helminth eggs’morphological tests(Direct smear and Kato-Katz).All of the results were scored and analyzed by using SPSS statistics 19.0 software.Results:The percentage of participants who had EQA score≥60 during 2012-2015 for direct smear test were 80.00%(2012),71.43%(2013),100%(2014)and 75.00%(2015),whereas for Kato-Katz test were 80.00%(2012),57.14%(2013),100%(2014)and 37.50%(2015),respectively.The detection rate of helminth eggs varied in different species,with Ascaris lumbricoides being the highest at 94.07%in average.All laboratories did very well with ELISA tests as shown by the high scores in all four years except Lab A in the first and last EQA.For the positive or negative judgments of serum samples,the total coincidence rates of ELISA between 2012 and 2015 were 90.00%,99.29%,94.29%and 98.75%,respectively.While the total coincidence rates of IHA were respectively 100%,95.00%,90.00%and 97.50%.However,detecting low levels of serum antibody remained problematic for IHA when the titres of samples were taken into consideration.Conclusion:This study demonstrate that EQA scheme have been beneficial to the participating laboratories.The EQA programme identifies certain deficiencies which were needed to overcome and improved the laboratories’performance in helminthiasis diagnosis.However,further optimization of accuracy and uniformity in NTDs diagnosis remains a big challenge.

Characteristics of crustal variation and extensional break-up in the Western Pacific back-arc region based on a wide-angle seismic profile

The marginal sea and back-arc basins in the Western Pacific Ocean have become the focus of tectonics due to their unique tectonic location.To understand the deep crustal structure in the back-arc region,we present a 545-kmlong active-source ocean bottom seismometer(OBS)wide-angle reflection/refraction profile in the East China Sea.The P wave velocity model shows that the Moho depth rises significantly,from approximately 30 km in the East China Sea shelf to approximately 16 km in the axis of the Okinawa Trough.The lower crustal high-velocity zone(HVZ)in the southern Okinawa Trough,with V_(p) of 6.8-7.3 km/s,is a remarkable manifestation of the mantle material upwelling and accretion to the lower crust.This confirms that the lower crustal high-velocity mantle accretion is developed in the southern Okinawa Trough.During the process of back-arc extension,the crustal structure of the southern Okinawa Trough is completely invaded and penetrated by the upper mantle material in the axis region.In some areas of the southern central graben,the crust may has broken up and entered the initial stage of seafloor spreading.The discontinuous HVZs in the lower crust in the back-arc region also indicate the migration of spreading centers in the back-arc region since the Cenozoic.The asthenosphere material upwelling in the continent-ocean transition zone is constantly driving the lithosphere eastward for episodic extension,and is causing evident tectonic migration in the Western Pacific back-arc region.